Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial
Yoshinori Kosaki,
Takashi Hongo,
Mineji Hayakawa
et al.
Abstract:Background
The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion strategy may differ based on lactate levels. This post hoc analysis of the RESTRIC trial sought to investigate the association between transfusion strategies and patient outcomes based on initial lactate levels.
Meth… Show more
“…This may be because lactate, as a biomarker of inadequate tissue perfusion, is highly correlated with the overall burden of trauma in PT patients. In addition, the included patients presented with a very high ISS compared to other studies that investigated the role of lactate in PT [ 1 , 7 , 16 , 19 ]. However, the present study demonstrated that serum LDH levels exhibited a correlation with the occurrence of concomitant chest injuries among patients afflicted with PT.…”
Background
Chest injury is an important factor regarding the prognosis of patients with polytrauma (PT), and the rapid diagnosis of chest injury is of utmost importance. Therefore, the current study focused on patients’ physiology and laboratory findings to quickly identify PT patients with chest injury.
Method
Data on 64 PT patients treated at a trauma center level I between June 2020 and August 2021 were retrospectively collected. The patients were divided into a PT group without chest injury (Group A) and a PT group including chest injury (Group B). The relationship between chest injury and the patients’ baseline characteristics and biochemical markers was analyzed.
Results
Heart rate, respiration rate, Sequential Organ Failure Assessment (SOFA) score, glutamate oxaloacetate aminotransferase (GOT), glutamate pyruvate transaminase (GPT), creatine kinase MB (CK-MB), leucocytes, hemoglobin (Hb), platelets, urine output, lactate, and lactate dehydrogenase (LDH) in groups A and B exhibited statistically significant differences at certain time points. Multifactorial analysis showed that blood LDH levels at admission were associated with chest injury (P = 0.039, CI 95% 1.001, 1.022).
Conclusion
LDH may be a promising indicator for screening for the presence of chest injury in patients with severe polytrauma.
“…This may be because lactate, as a biomarker of inadequate tissue perfusion, is highly correlated with the overall burden of trauma in PT patients. In addition, the included patients presented with a very high ISS compared to other studies that investigated the role of lactate in PT [ 1 , 7 , 16 , 19 ]. However, the present study demonstrated that serum LDH levels exhibited a correlation with the occurrence of concomitant chest injuries among patients afflicted with PT.…”
Background
Chest injury is an important factor regarding the prognosis of patients with polytrauma (PT), and the rapid diagnosis of chest injury is of utmost importance. Therefore, the current study focused on patients’ physiology and laboratory findings to quickly identify PT patients with chest injury.
Method
Data on 64 PT patients treated at a trauma center level I between June 2020 and August 2021 were retrospectively collected. The patients were divided into a PT group without chest injury (Group A) and a PT group including chest injury (Group B). The relationship between chest injury and the patients’ baseline characteristics and biochemical markers was analyzed.
Results
Heart rate, respiration rate, Sequential Organ Failure Assessment (SOFA) score, glutamate oxaloacetate aminotransferase (GOT), glutamate pyruvate transaminase (GPT), creatine kinase MB (CK-MB), leucocytes, hemoglobin (Hb), platelets, urine output, lactate, and lactate dehydrogenase (LDH) in groups A and B exhibited statistically significant differences at certain time points. Multifactorial analysis showed that blood LDH levels at admission were associated with chest injury (P = 0.039, CI 95% 1.001, 1.022).
Conclusion
LDH may be a promising indicator for screening for the presence of chest injury in patients with severe polytrauma.
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