Blood Transfusion Indicators Following Trauma in the Non-Massively Bleeding Patient.

BACKGROUND: Establishing transfusion guidelines during trauma resuscitation is challenging. Our objective was to evaluate indications for transfusion in trauma patients who emergently received ≤2 units of red blood cells (RBC) during the first hour of resuscitation.

METHODS: A single center retrospective study included non-massively bleeding trauma patients stratified into 2 groups: 1) with a clinical indication for transfusion and 2) with no indication for transfusion. Admission vital signs (VS), injury severity score (ISS), shock index, and laboratory values were compared between the two groups using the Wilcoxon rank-sum test.

RESULTS: Among 111 non-massively bleeding trauma patients, 40 presented no indication for transfusion. All patients presented similar ISS and VS. The 71 patients presenting with an indication for transfusion had higher bicarbonate (22.6 vs 20.8) and lower lactate levels (4.7 v 6.6) ( p <0.05).

CONCLUSION: Lactate and bicarbonate blood levels may be potential indicators for RBC transfusion need during trauma resuscitation in non-massively bleeding patients.