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Who's doing 1:1 blood transfusions for shock?

William Bromberg brombwi1 at memorialhealth.com
Wed Feb 13 13:28:49 GMT 2008

Also, have you all seen the new whitepaper from the transfusion medicine people about TRALI and the use of female plasma? It looks like the plasma supply just got cut in half more or less. The link is from the lay press (but not a bad article).



>>> "Karim Brohi" <karim at trauma.org> 2/12/2008 6:41 PM >>>
<<  It has NOT been universally accepted, however, and I am not sure why. >>

Because one swallow doesn't make a spring, and one retrospective military
study shouldn't change global practice.


There are significant implications for providing 1:1 plasma instead of 1:3 -
more use of AB plasma, increased risks, increased work for transfusion
staff, increased likelihood of error, and inability to keep up (Par
Johansson, a world-class transfusionist in Copenhagen has been running 1:1
for years and has modelled resource provision.  He is clear that provision
of 1:1 ratios during multiple casualty events is almost impossible).

Now I'm not saying that 1:1 is not the right thing to do.   It may be, but
we have a suggestion of effect and that is all at present.  Read the
Cochrane review on plasma therapy - for any indication.  There's so little
evidence out there it behoves us to investigate this more thoroughly before
we expose our patients to 3-4 times the dose of a product we have little
knowledge of.

Sadly I'm speaking 'For' 1:1 in Vegas - which is much easier and more boring


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