Effect of Early Equal-Proportional Infusion of Plasma and Red Blood Cells on the Prognosis of Emergency Patients with Traumatic Hemorrhage.

BACKGROUND: The goal was to study the effect of early equal-proportion transfusion on the prognosis of trauma patients with bleeding. METHODS: Emergency hospital trauma patients were randomly divided into two groups, a group based on assessment of blood consumption (ABC) to assess whether need to start the massive blood transfusion patients, such as proportion of blood transfusion (fresh frozen plasma: suspended red blood cells = 1:1), and the other group using traditional methods of blood transfusion, namely according to routine blood and clotting function and hemodynamic parameters, to decide when and what blood constituents should be transfused. RESULTS: The coagulation got better in the early equal-proportion transfusion group, there were significant differences of PT and APTT (p < 0.05). The amount of 24 hours RBC and plasma transfusion was decreased in the early equal-proportion transfusion group, compared to the control group (p < 0.05), the length of ICU stay was shortened, the 24-hours SOFA score was improved, and there was no significant difference in 24-hours mortality, in-hospital mortality and total length of in-hospital stay (p > 0.05). CONCLUSIONS: Early transfusion can reduce the total amount of blood transfusion and shorten ICU time, but has no significant effect on mortality.

Serum HMGB1 and soluble urokinase plasminogen activator receptor levels aid diagnosis and prognosis prediction of sepsis with acute respiratory distress syndrome.

Objective: To study the clinical application of serum HMGB1 and soluble urokinase plasminogen activator receptor (suPAR) expression in sepsis with acute respiratory distress syndrome (ARDS). Methods: Clinical data of 303 septic patients with/without ARDS were documented. Levels of serum inflammatory markers and HMGB1/suPAR were measured. ARDS patients were subdivided into high and low HMGB1/suPAR expression groups and followed up. Results: Serum HMGB1 and suPAR were upregulated in ARDS patients and positively correlated with inflammatory markers. The combination of HMGB1 with suPAR surpassed HMGB1 or suPAR alone in aiding diagnosis of sepsis with ARDS. CRP, PCT, IL-6, HMGB1 and suPAR were independent risk factors for ARDS. High HMGB1/suPAR expression might be linked to poor prognosis. Conclusion: Serum HMGB1/suPAR levels might aid diagnosis and predict poor prognosis of septic patients with ARDS.

The incidence and mortality rates of acute respiratory distress syndrome (ARDS) attributed to sepsis are considerably high. Early prediction of the occurrence of ARDS is of great significance for clinical treatment and guidance evaluation. This study showed that HMGB1 and soluble urokinase plasminogen activator receptor (suPAR) were highly expressed in the serum of septic patients with ARDS, and that the inflammatory reaction of septic patients with high expression levels of HMGB1 or suPAR was more serious, meaning that sepsis was more likely to cause ARDS. Concurrent measurement of HMGB1 and suPAR was more effective than measurement of HMGB1 or suPAR alone. This study demonstrated that high expression levels of serum HMGB1 and suPAR may increase the risk of poor prognosis (such as death) in septic patients with ARDS. In conclusion, this study measured the expression levels of serum HMGB1 and suPAR, thus providing a theoretical reference for the clinical diagnosis and prognosis of patients with ARDS attributed to sepsis.