Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis
Abstract Purpose We sought to determine if use of warm fresh whole blood (WFWB), rather than blood component therapy, alters rates of acute lung injury (ALI) in patients with trauma. Materials and Methods We retrospectively analyzed rates of ALI in patients undergoing massive blood transfusions whil...
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| Veröffentlicht in: | Journal of critical care 2012-08, Vol.27 (4), p.419.e7-419.e14 |
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| creator | Chan, Chee M., MD, MPH Shorr, Andrew F., MD, MPH Perkins, Jeremy G., MD, FACP |
| description | Abstract Purpose We sought to determine if use of warm fresh whole blood (WFWB), rather than blood component therapy, alters rates of acute lung injury (ALI) in patients with trauma. Materials and Methods We retrospectively analyzed rates of ALI in patients undergoing massive blood transfusions while at a combat support hospital. Patients with ALI were compared with those not developing ALI with respect to demographics, trauma type, severity of illness, crystalloid volume given, and exposure to WFWB. Logistic regression was used to identify variables associated with ALI. Results The cohort included 591 subjects (mean age, 28 ± 8.1 years; male, 96.7%). Acute lung injury occurred in 11.2%, and 34.4% received WFWB. After adjusting for the type of trauma, severity of illness, and volume of crystalloid administered, WFWB remained independently associated with ALI (adjusted odds ratio [AOR], 1.06; 95% confidence interval [CI], 1.00-1.13). Nearly two thirds of persons with ALI never received WFWB; factors associated with the use of WFWB were also examined. Severity of illness (AOR, 1.18; 95% CI, 1.02-1.35), crystalloid volume (AOR, 1.12; 95% CI, 1.06-1.18), recombinant factor VIIa use (AOR, 1.94; 95% CI, 1.06-3.57), and US citizenship (AOR, 3.06; 95% CI, 1.74-5.37) correlated with WFWB use. Conclusions Warm fresh whole blood may be associated with an increased risk of ALI, but this is confounded by increased injury and crystalloid use in patients receiving WFWB. |
| doi_str_mv | 10.1016/j.jcrc.2011.11.010 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1027836067</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S088394411100493X</els_id><sourcerecordid>1027836067</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-41fc55e38e0906bf946a6bab5ef23a455f80e950fa5f89d66c36c387093665d3</originalsourceid><addsrcrecordid>eNp9ksFu1DAQhi1ERZfCC3BAlrhwyWLHseMgVKmqKCBV6oEeuFmOMwGHJF48zqI99N1xtAWkHmqNND5882tm_iHkFWdbzrh6N2wHF922ZJxvczDOnpANl7IutOLyKdkwrUXRVBU_Jc8RB8Z4LYR8Rk7L_Gqm5YbcXVmXQkRqEYPzNkFHf_v0g1q3JKDjMn-nfh6WeMiJujC1NlFncbFj8oA0ggO_95masoLfA23HEDqaop2xX9CHGd_Ti8ylGHAHLq2Mne14QI8vyElvR4SX9_mM3F59vL38XFzffPpyeXFduEqLVFS8d1KC0MAaptq-qZRVrW0l9KWwlZS9ZtBI1tv8azqlnMiha9YIpWQnzsjbo-wuhl8LYDKTRwfjaGcICxrOyloLxVSd0TcP0CEsMbe7UkI1UutGZqo8Ui4PhRF6s4t-svGQIbN6YwazemNWb0yO7E0uen0vvbQTdP9K_pqRgQ9HAPIq9h6iQedhdtD5vOZkuuAf1z9_UO5GP3tnx59wAPw_h8HSMPN1vY71ODhnrGrEN_EHLA-2jg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1036958895</pqid></control><display><type>article</type><title>Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Chan, Chee M., MD, MPH ; Shorr, Andrew F., MD, MPH ; Perkins, Jeremy G., MD, FACP</creator><creatorcontrib>Chan, Chee M., MD, MPH ; Shorr, Andrew F., MD, MPH ; Perkins, Jeremy G., MD, FACP</creatorcontrib><description>Abstract Purpose We sought to determine if use of warm fresh whole blood (WFWB), rather than blood component therapy, alters rates of acute lung injury (ALI) in patients with trauma. Materials and Methods We retrospectively analyzed rates of ALI in patients undergoing massive blood transfusions while at a combat support hospital. Patients with ALI were compared with those not developing ALI with respect to demographics, trauma type, severity of illness, crystalloid volume given, and exposure to WFWB. Logistic regression was used to identify variables associated with ALI. Results The cohort included 591 subjects (mean age, 28 ± 8.1 years; male, 96.7%). Acute lung injury occurred in 11.2%, and 34.4% received WFWB. After adjusting for the type of trauma, severity of illness, and volume of crystalloid administered, WFWB remained independently associated with ALI (adjusted odds ratio [AOR], 1.06; 95% confidence interval [CI], 1.00-1.13). Nearly two thirds of persons with ALI never received WFWB; factors associated with the use of WFWB were also examined. Severity of illness (AOR, 1.18; 95% CI, 1.02-1.35), crystalloid volume (AOR, 1.12; 95% CI, 1.06-1.18), recombinant factor VIIa use (AOR, 1.94; 95% CI, 1.06-3.57), and US citizenship (AOR, 3.06; 95% CI, 1.74-5.37) correlated with WFWB use. Conclusions Warm fresh whole blood may be associated with an increased risk of ALI, but this is confounded by increased injury and crystalloid use in patients receiving WFWB.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2011.11.010</identifier><identifier>PMID: 22227085</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute lung injury ; Acute Lung Injury - epidemiology ; Acute Lung Injury - etiology ; Adult ; Age Factors ; Bias ; Blast Injuries - complications ; Blast Injuries - epidemiology ; Blast Injuries - therapy ; Blood products ; Blood Transfusion - methods ; Combat casualties ; Critical Care ; Female ; Health sciences ; Hospitals ; Hospitals, Military ; Humans ; Hypotheses ; Iraq War, 2003-2011 ; Male ; Massive transfusions ; Military Personnel ; Mortality ; Outcomes ; Penetrating wounds ; Retrospective Studies ; Review boards ; Risk factors ; Sex Factors ; Transfusion Reaction ; Trauma Severity Indices ; United States ; Warm fresh whole blood</subject><ispartof>Journal of critical care, 2012-08, Vol.27 (4), p.419.e7-419.e14</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-41fc55e38e0906bf946a6bab5ef23a455f80e950fa5f89d66c36c387093665d3</citedby><cites>FETCH-LOGICAL-c483t-41fc55e38e0906bf946a6bab5ef23a455f80e950fa5f89d66c36c387093665d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S088394411100493X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22227085$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Chee M., MD, MPH</creatorcontrib><creatorcontrib>Shorr, Andrew F., MD, MPH</creatorcontrib><creatorcontrib>Perkins, Jeremy G., MD, FACP</creatorcontrib><title>Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose We sought to determine if use of warm fresh whole blood (WFWB), rather than blood component therapy, alters rates of acute lung injury (ALI) in patients with trauma. Materials and Methods We retrospectively analyzed rates of ALI in patients undergoing massive blood transfusions while at a combat support hospital. Patients with ALI were compared with those not developing ALI with respect to demographics, trauma type, severity of illness, crystalloid volume given, and exposure to WFWB. Logistic regression was used to identify variables associated with ALI. Results The cohort included 591 subjects (mean age, 28 ± 8.1 years; male, 96.7%). Acute lung injury occurred in 11.2%, and 34.4% received WFWB. After adjusting for the type of trauma, severity of illness, and volume of crystalloid administered, WFWB remained independently associated with ALI (adjusted odds ratio [AOR], 1.06; 95% confidence interval [CI], 1.00-1.13). Nearly two thirds of persons with ALI never received WFWB; factors associated with the use of WFWB were also examined. Severity of illness (AOR, 1.18; 95% CI, 1.02-1.35), crystalloid volume (AOR, 1.12; 95% CI, 1.06-1.18), recombinant factor VIIa use (AOR, 1.94; 95% CI, 1.06-3.57), and US citizenship (AOR, 3.06; 95% CI, 1.74-5.37) correlated with WFWB use. Conclusions Warm fresh whole blood may be associated with an increased risk of ALI, but this is confounded by increased injury and crystalloid use in patients receiving WFWB.</description><subject>Acute lung injury</subject><subject>Acute Lung Injury - epidemiology</subject><subject>Acute Lung Injury - etiology</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Bias</subject><subject>Blast Injuries - complications</subject><subject>Blast Injuries - epidemiology</subject><subject>Blast Injuries - therapy</subject><subject>Blood products</subject><subject>Blood Transfusion - methods</subject><subject>Combat casualties</subject><subject>Critical Care</subject><subject>Female</subject><subject>Health sciences</subject><subject>Hospitals</subject><subject>Hospitals, Military</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Iraq War, 2003-2011</subject><subject>Male</subject><subject>Massive transfusions</subject><subject>Military Personnel</subject><subject>Mortality</subject><subject>Outcomes</subject><subject>Penetrating wounds</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Risk factors</subject><subject>Sex Factors</subject><subject>Transfusion Reaction</subject><subject>Trauma Severity Indices</subject><subject>United States</subject><subject>Warm fresh whole blood</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ksFu1DAQhi1ERZfCC3BAlrhwyWLHseMgVKmqKCBV6oEeuFmOMwGHJF48zqI99N1xtAWkHmqNND5882tm_iHkFWdbzrh6N2wHF922ZJxvczDOnpANl7IutOLyKdkwrUXRVBU_Jc8RB8Z4LYR8Rk7L_Gqm5YbcXVmXQkRqEYPzNkFHf_v0g1q3JKDjMn-nfh6WeMiJujC1NlFncbFj8oA0ggO_95masoLfA23HEDqaop2xX9CHGd_Ti8ylGHAHLq2Mne14QI8vyElvR4SX9_mM3F59vL38XFzffPpyeXFduEqLVFS8d1KC0MAaptq-qZRVrW0l9KWwlZS9ZtBI1tv8azqlnMiha9YIpWQnzsjbo-wuhl8LYDKTRwfjaGcICxrOyloLxVSd0TcP0CEsMbe7UkI1UutGZqo8Ui4PhRF6s4t-svGQIbN6YwazemNWb0yO7E0uen0vvbQTdP9K_pqRgQ9HAPIq9h6iQedhdtD5vOZkuuAf1z9_UO5GP3tnx59wAPw_h8HSMPN1vY71ODhnrGrEN_EHLA-2jg</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Chan, Chee M., MD, MPH</creator><creator>Shorr, Andrew F., MD, MPH</creator><creator>Perkins, Jeremy G., MD, FACP</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis</title><author>Chan, Chee M., MD, MPH ; Shorr, Andrew F., MD, MPH ; Perkins, Jeremy G., MD, FACP</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-41fc55e38e0906bf946a6bab5ef23a455f80e950fa5f89d66c36c387093665d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acute lung injury</topic><topic>Acute Lung Injury - epidemiology</topic><topic>Acute Lung Injury - etiology</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Bias</topic><topic>Blast Injuries - complications</topic><topic>Blast Injuries - epidemiology</topic><topic>Blast Injuries - therapy</topic><topic>Blood products</topic><topic>Blood Transfusion - methods</topic><topic>Combat casualties</topic><topic>Critical Care</topic><topic>Female</topic><topic>Health sciences</topic><topic>Hospitals</topic><topic>Hospitals, Military</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Iraq War, 2003-2011</topic><topic>Male</topic><topic>Massive transfusions</topic><topic>Military Personnel</topic><topic>Mortality</topic><topic>Outcomes</topic><topic>Penetrating wounds</topic><topic>Retrospective Studies</topic><topic>Review boards</topic><topic>Risk factors</topic><topic>Sex Factors</topic><topic>Transfusion Reaction</topic><topic>Trauma Severity Indices</topic><topic>United States</topic><topic>Warm fresh whole blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Chee M., MD, MPH</creatorcontrib><creatorcontrib>Shorr, Andrew F., MD, MPH</creatorcontrib><creatorcontrib>Perkins, Jeremy G., MD, FACP</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Chee M., MD, MPH</au><au>Shorr, Andrew F., MD, MPH</au><au>Perkins, Jeremy G., MD, FACP</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>27</volume><issue>4</issue><spage>419.e7</spage><epage>419.e14</epage><pages>419.e7-419.e14</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose We sought to determine if use of warm fresh whole blood (WFWB), rather than blood component therapy, alters rates of acute lung injury (ALI) in patients with trauma. Materials and Methods We retrospectively analyzed rates of ALI in patients undergoing massive blood transfusions while at a combat support hospital. Patients with ALI were compared with those not developing ALI with respect to demographics, trauma type, severity of illness, crystalloid volume given, and exposure to WFWB. Logistic regression was used to identify variables associated with ALI. Results The cohort included 591 subjects (mean age, 28 ± 8.1 years; male, 96.7%). Acute lung injury occurred in 11.2%, and 34.4% received WFWB. After adjusting for the type of trauma, severity of illness, and volume of crystalloid administered, WFWB remained independently associated with ALI (adjusted odds ratio [AOR], 1.06; 95% confidence interval [CI], 1.00-1.13). Nearly two thirds of persons with ALI never received WFWB; factors associated with the use of WFWB were also examined. Severity of illness (AOR, 1.18; 95% CI, 1.02-1.35), crystalloid volume (AOR, 1.12; 95% CI, 1.06-1.18), recombinant factor VIIa use (AOR, 1.94; 95% CI, 1.06-3.57), and US citizenship (AOR, 3.06; 95% CI, 1.74-5.37) correlated with WFWB use. Conclusions Warm fresh whole blood may be associated with an increased risk of ALI, but this is confounded by increased injury and crystalloid use in patients receiving WFWB.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22227085</pmid><doi>10.1016/j.jcrc.2011.11.010</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Acute lung injury Acute Lung Injury - epidemiology Acute Lung Injury - etiology Adult Age Factors Bias Blast Injuries - complications Blast Injuries - epidemiology Blast Injuries - therapy Blood products Blood Transfusion - methods Combat casualties Critical Care Female Health sciences Hospitals Hospitals, Military Humans Hypotheses Iraq War, 2003-2011 Male Massive transfusions Military Personnel Mortality Outcomes Penetrating wounds Retrospective Studies Review boards Risk factors Sex Factors Transfusion Reaction Trauma Severity Indices United States Warm fresh whole blood |
| title | Factors associated with acute lung injury in combat casualties receiving massive blood transfusions: A retrospective analysis |
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