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Transfusion pré-hospitalière de culots de globules rouges : analyse rétrospective des pratiques au SMUR du CHU de Nîmes et perspective d’un protocole basé sur les preuves
Mémoire de Master / Thèse d'exercice   Open Access

Transfusion pré-hospitalière de culots de globules rouges : analyse rétrospective des pratiques au SMUR du CHU de Nîmes et perspective d’un protocole basé sur les preuves

Martin Corbefin
Masters , Université de Montpellier
08/10/2024

Résumé

Prehospital blood transfusion Transfusion practices Red blood cells Protocol Sang -- Transfusion Premiers soins Services d'urgence médicale Service mobile d'urgence et de réanimation Protocole Transfusion sanguine Ambulances Érythrocytes Emergency medical service
The benefit of prehospital transfusion (PHT) is uncertain. We aimed to describe the patients who received PHT in our mobile intensive care unit. Methods: this was a retrospective, observational, monocentric study of patients for whom a decision has been made to initiate an SMUR transport with packed red blood cells (RBC) between January 1st 2015 and December 31rd 2023. Results: 103 patients were analysed and 69 (67%) benefited PHT. Patients who benefited PHT were treated at sites further away from the hospital (34km [11; 57] vs. 20km [5; 35], p = 0.04), they had a lower mean blood pressure (MBP) and a higher Shock Index (SI) at the initial call and at SMUR management (MBP = 58 mmHg [50; 70] vs. 74 mmHg [63; 96]; p = 0.01 and SI = 1.2 bpm. mmHg-1 [1.0; 1.6] vs. 0.9 bpm. mmHg-1 [0.7; 0.9]; p = 0. 02; MBP = 63 mmHg [48; 73] vs 83 mmHg [63; 94]; p < 0.01 and SI = 1.3 bpm.mmHg-1 [0.9; 1.7] vs 0.8 [0.7; 1.2] bpm.mmHg-1; p < 0.01). Conclusion: patients receiving PHT were more distant from hospitals and haemodynamically unstable. Objective criteria are needed to initiate PHT.

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