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13% of injured normotensive patients arriving in emergency unit need mass blood-transfusion of six or more units of packed Red Blood Cells. It is currently difficult to predict the need for such a mass blood-transfusion. Indeed hemoglobin point of care testing (hemocue) and blood pressure can be normal during the first hours despite intensive bleeding.
It's well known that blood or arterial lactate measures correlate with trauma severity but these measures are not available in a pre-hospital setting. The investigators want to test whether capillary lactate measures also correlate with trauma severity and can therefore predicts earlier transfusion needs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Injured patient admitted in vital emergency unit |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Capillary lactate level | Other | Use of capillary sample to determine lactate level upon arrival at vital emergency unit and at 2 hours |
|
| Measure | Description | Time Frame |
|---|---|---|
| Transfusion of 6 or more units of packed Red Blood Cells (RBC) | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| arterial lactate measures | upon arrival at the vital emergency unit | |
| injury scores (ISS,SOFA) | 24h | |
| transfusion of 4 units of packed RBC |
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Inclusion Criteria:
Exclusion Criteria:
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Adults admitted in vital emergency unit due to severe trauma based on a local severity score.
Patients are normotensive
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| Name | Affiliation | Role |
|---|---|---|
| Marc Vinclair, MD | University Hospital, Grenoble | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Grenoble University Hospital | La Tronche | Isere | 38700 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27267942 | Derived | Bouzat P, Schilte C, Vinclair M, Manhes P, Brun J, Bosson JL, Payen JF. Capillary lactate concentration on admission of normotensive trauma patients: a prospective study. Scand J Trauma Resusc Emerg Med. 2016 Jun 7;24:82. doi: 10.1186/s13049-016-0272-x. |
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| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| 48 hours |
| blood lactate measure | upon arrival at vital emergency unit |
| Intensity of medical care | Body scan Central venous catheterisation arterial catheterisation | upon arrival at vital emergency unit |
| Bleeding Predictive Score | 3 questions are asked to the doctor in emergency room. Could patient be admitted directly at the CT scan ? Do you think that the patient need transfusion ? If Yes : and how many units ? Do you think that the patient will be hospitalized in an intensive care unit after the emergency room? | upon arrival at vital emergency unit |
| Mortality | 28 days |