Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission.

Autor:	Silva ALO; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Bassolli L; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil., Ferreira P; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil., Utiyama E; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil., Dezan MR; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Costa-Neto A; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil., Conrado MCAV; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Oliveira VB; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Bonifácio SL; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Fernandes FLA; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil; Departamento de Pneumologia, Faculdade de Medicina da Universidade de São Paulo, SP, Brazil., Rocha V; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil; Churchill Hospital, NHS BT, Oxford University, Oxford, United Kingdom., Mendrone-Júnior A; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil., Dinardo CL; Fundação Pró-Sangue (Hemocentro), São Paulo, SP, Brazil; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil; Instituto de Medicina Tropical, University of São Paulo, São Paulo, SP, Brazil. Electronic address: carlaluana@usp.br.
Jazyk:	angličtina
Zdroj:	Hematology, transfusion and cell therapy [Hematol Transfus Cell Ther] 2021 Jul-Sep; Vol. 43 (3), pp. 287-294. Date of Electronic Publication: 2020 Aug 06.
DOI:	10.1016/j.htct.2020.06.011
Abstrakt:	Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48-7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38-38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks. (Copyright © 2020 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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