While correction of coagulopathy involves delivering high ratios of fresh frozen plasma (FFP) and platelets to packed red blood cells (pBRC), calcium-dependent pathways involved in both intrinsic and extrinsic pathway hemostasis and platelet function are disrupted by bleeding and hemostatic resuscitation itself. Therefore, randomized prospective studies are suggested.Įxsanguination and hemorrhagic shock continue to be some of the most preventable causes of death following trauma therefore, trauma resuscitation is based on early recognition of bleeding, correction, and prevention of factors perpetuating exsanguination such as hypothermia, acidosis, and coagulopathy. Only retrospective studies such as ours are available, and while hypocalcemia seems to be an independent predictor of mortality and massive transfusion, there is not enough evidence to support causation. 92, p < 0.001, respectively), resulting in a higher shock index (SI) (1.1 vs.
Prehospital data showed a lower mean systolic arterial pressure (SAP) and a higher heart rate (HR) in the HC group (105 vs. ISS was higher in the HC group and was an independent, even if weak, predictor of hypocalcemia (odds ratio 1.03, p = 0.03). Demographic data showed no significant difference between hypocalcemic (HC) and normocalcemic (NC) patients except for the presence of crush trauma, alcohol intake (27% vs. A total of 798 patients were eligible out of 1586 screened. All major trauma (ISS > 16) presented directly from the scene to the Niguarda hospital between 1 January 2015 and 31 December 2021 were analyzed. The aim of this study was to analyze a cohort of severe trauma patients to identify risk factors associated with massive transfusion requirements and hypocalcemia. The rapid identification of patients at risk for massive blood transfusion is of paramount importance as uncontrolled exsanguination may lead to death within 2 to 6 h.
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