The development and feasibility of a remote damage control resuscitation prehospital plasma iransfusion protocol for warfarin reversal for patients with traumatic brain injury

摘要

Traumatic brain injury (TBI) is the most common cause of death whether on the battlefield or within the civilian arena and is highly associated with concurrent injuries that can cause massive hemorrhage.1 Prehospital treatment of hypocoagulable states, however, has not kept pace with advances instituted upon admission at military and civilian hospitals. These therapies include in-hospital rapid reversal of warfarin, in addition to massive transfusion (MT) protocols for hemorrhaging patients. Protocols such as these have been associated with significant mortality improvements by likely controlling hemorrhage and restoring blood flow.2 The ideal fluid for resuscitation, therefore, maintains circulating volume, vital organ perfu-sion and augments hemostasis via coagulation protein replenishment.