Influence of plasma to red blood cell ratio on coagulation function and risk of adverse events in patients with massive transfusion

Abstract

Objective To investigate the influence of the ratio difference of plasma and red blood cells on blood coagulation function and the adverse events risk of patients with massive blood transfusion. Methods Three hundred and two patients with massive blood transfusion were divided into two groups including normal group (276 patients) and abnormal group (26 patients) according the blood coagulation function and divided into three groups including high ratio group, medium ratio group and low ratio group according the ratio of plasma and red blood cells; and the levels of prothrombin time(PT), activated partial thromboplatin time(APTT), thrombin time(TT) and fibrinogen(FIB) before and after treatment and the incidence of adverse events of different groups were compared. Results The levels of PT, APTT and TT after treatment of low ratio group with normal blood coagulation function were significant longer than those before treatment, and lower than those of medium ratio group and high ration group after treatment(P 0.05). The incidence of blood coagulation dysfunction and death of low ratio group with normal blood coagulation function were significant higher than those of medium ratio group and high ration group(P<0.05). The incidence of blood coagulation dysfunction of high ratio group with abnormal blood coagulation function were significant lower than those of medium ratio group and low ration group(P<0.05). The mortality of low ratio group with abnormal blood coagulation function were significant higher than those of medium ratio group and high ration group(P<0.05). Conclusions The regulation for the ratio of plasma and red blood cell of patients with massive blood transfusion should be based on blood coagulation function, and the patients with blood coagulation function of normal and abnormal should fellow plasma and red blood cell ratio as 1∶1 and 2∶1. Key words: Plasma; Red blood cell; Blood transfusion; Blood coagulation function; Adverse events