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Resuscitation in the Combat Injured

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Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study.
Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ.
Arch Surg. 2012 Feb;147(2):113-9.

Rationale for inclusion: This is the first military study on the use of TXA in conjunction with blood component-based resuscitation in combat casualties. Improved survival was seen in those patients who received TXA and was more prominent in those requiring massive transfusion. 

Citations - 390 (as of July 2017)

Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries.
Spinella PC, Perkins JG, Grathwohl KW, Beekley AC, Holcomb JB.
J Trauma. 2009 Apr;66(4 Suppl):S69-76.

Rationale for inclusion: The military experience with fresh whole blood transfusions is largely out of necessity due to the inability to store adequate component products at forward surgical units. This retrospective study demonstrates that there is a survival advantage to WFWB transfusion in patients with hemorrhagic shock.

Citations - 230 (as of July 2017)

An evaluation of the impact of apheresis platelets used in the setting of massively transfused trauma patients.
Perkins JG, Cap AP, Spinella PC, Blackbourne LH, Grathwohl KW, Repine TB, Ketchum L, Waterman P, Lee RE, Beekley AC, Sebesta JA, Shorr AF, Wade CE, Holcomb JB.
J Trauma. 2009 Apr;66(4 Suppl):S77-84; discussion S84-5.

Rationale for inclusion: This study represents a large cohort of patients treated at a combat hosptial in Iraq. Those requiring massive transfusion who received apheresed platelets in high aPLT:RBC ratio > 1:8 had improved survival.

Citations - 139 (as of July 2017)

Increased mortality associated with the early coagulopathy of trauma in combat casualties.
Niles SE, McLaughlin DF, Perkins JG, Wade CE, Li Y, Spinella PC, Holcomb JB.
J Trauma. 2008 Jun;64(6):1459-63; discussion 1463-5.

Rationale for inclusion: In this retrospective review of combat trauma patients, acute coagulopathy was associated with mortality, similar to civilian trauma patients.

Citations - 320 (as of July 2017)

The ratio of fibrinogen to red cells transfused affects survival in casualties receiving massive transfusions at an army combat support hospital.
Stinger HK, Spinella PC, Perkins JG, Grathwohl KW, Salinas J, Martini WZ, Hess JR, Dubick MA, Simon CD, Beekley AC, Wolf SE, Wade CE, Holcomb JB.
J Trauma. 2008 Feb;64(2 Suppl):S79-85; discussion S85.

Rationale for inclusion: In combat trauma patients who were found to need massive transfusion and also received higher ratios of fibrinogen:RBC there was increased survival. 

Citations - 364 (as of July 2017)

Risks associated with fresh whole blood and red blood cell transfusions in a combat support hospital.
Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, Sebesta J, Jenkins D, Azarow K, Holcomb JB; 31st Combat Support Hospital Research Working Group.
Crit Care Med. 2007 Nov;35(11):2576-81.

Rationale for inclusion:  The use of WFWB transfusion, especially in combat resusciation, is known to incur a survival advantage. Concerns over safety of FWB tranfsusion exist. This study shows that the risk of infection disease transmission can be minimized for FWB transfusion in a pre-screened miiltary combat environment. 

Citations - 115 (as of July 2017)

The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital.
Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, Sebesta J, Jenkins D, Wade CE, Holcomb JB.
J Trauma. 2007 Oct;63(4):805-13.

Rationale for inclusion: This retrospective review of combat patients requiring massive tranfusion showed that those who received high plasma to PRBC ratios had improved survival. This is clearly a landmark paper that significantly impacted both military and civilian blood resuscitation therapy and massive transfusion protocols.

Citations - 1252 (as of July 2017)

Early predictors of massive transfusion in combat casualties.
Schreiber MA1, Perkins J, Kiraly L, Underwood S, Wade C, Holcomb JB.
J Am Coll Surg. 2007 Oct;205(4):541-5.

Rationale for inclusion: This is retrospective review of combat patients requiring massive transfusion. Massive transfusion in this group was associated with higher mortality, and variable present early upon admission can predict the need for massive transfusion.

Citations - 183 (as of July 2017)

Damage control resuscitation: directly addressing the early coagulopathy of trauma.
Holcomb JB, Jenkins D, Rhee P, Johannigman J, Mahoney P, Mehta S, Cox ED, Gehrke MJ, Beilman GJ, Schreiber M, Flaherty SF, Grathwohl KW, Spinella PC, Perkins JG, Beekley AC, McMullin NR, Park MS, Gonzalez EA, Wade CE, Dubick MA, Schwab CW, Moore FA, Champion HR, Hoyt DB, Hess JR.
J Trauma. 2007 Feb;62(2):307-10.

Rationale for inclusion: Although this is a commentary, it represents one of the earliest and most recognized discussions of damage control resusctation.

Citations - 956 (as of July 2017)

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