Giving specific blood components to trauma patients depending on their injuries might improve their odds of survival, researchers say.
For example, giving plasma that has been separated from other parts of donated blood improves outcomes in patients with head injuries or shock, whereas giving unseparated, or whole, blood may be best for other hemorrhaging patients, the researchers reported in Cell Reports Medicine.
The researchers looked at more than 1,000 injured patients who were likely to need emergency surgery and sampled their blood at set time points. They also studied 134 injured patients who received at least one unit of a blood product - red blood cells, plasma, platelets or whole blood – before admission to the hospital.
They found that receiving a higher proportion of separated plasma before arriving at the hospital, as opposed to plasma in whole blood, was associated with improved blood clotting in patients with severe shock and signs of head injury. It also reduced post-admission transfusions in patient with head injuries.
In blood sample analyses, researchers found the plasma likely had an impact on the proteins that help with inflammation, clotting and wound repair.
It is not clear, however, why patients who received separated plasma fared better and had blood sample findings more conducive to healing, compared to patients who received the same amount of plasma but in whole blood.
Whole blood can be kept for 21 days, while plasma alone has a five-day shelf life, the researchers noted.
"Perhaps when kept in whole blood the proteins in the plasma change over time, possibly because the blood cells release enzymes that act on the plasma proteins," study leader Dr. Jason Sperry of the University of Pittsburgh Medical Center said in a statement.
Sperry noted that it isn't practical for ambulances to carry plasma, since it expires so quickly and must be refrigerated.
"Our findings indicate that it is worthwhile to overcome these challenges," Sperry said.
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