Guidelines for Complications of Cancer Treatment Vol VIII Part B

than 1.5 times control values but fibrinogen levels are greaterthan 1 g/l and there is active bleeding, then transfusion at 12–15 ml/kg (approximately 4 packs for an adult) will increaselevels of the required coagulation factors. The potential riskof blood borne infection, including HIV and hepatitis, fromtransfusion of FFP is similar to that for whole blood. Although‘‘formula replacement’’ is not recommended it has beensuggested that FFP should be considered after loss of one bloodvolume.The ratio of blood products transfused affects mortalityin patients receiving massive transfusions at a combatsupport hospital.Borgman MA, Spinella PC, Perkins JG, Grathwohl KW,Repine T, Beekley AC, Sebesta J, Jenkins D, Wade CE,Holcomb JB: J Trauma 2007, 63:805-813 [1]Background : Patients with severe traumatic injuries oftenpresent with coagulopathy and require massive transfusion.The risk of death from hemorrhagic shock increases in thispopulation. To treat the coagulopathy of trauma, some havesuggested early, aggressive correction using a 1:1 ratio ofplasma to red blood cell (RBC) units.Objective: To determine whether the ratio of plasma to RBCstransfused would affect survival by decreasing death fromhemorrhage.Design: Retrospective chart review.Setting: United States Army combat support hospital in Iraq.Subjects: 246 patients who received a massive transfusion( 10 units of RBCs in 24 hours) from November 2003 toSeptember 2005. Three groups of patients were constructedaccording to the plasma to RBC ratio transfused during massivetransfusion.54