Establishment of NATO Trauma Registry—A Joint Project within the NAT Framework
Prehospital and Disaster Medicine
Abstracts-IPRED 2009 slOl could have implications for search-and-rescue teams, medical emergency teams, and other hazard profession staff. Background: The Netherlands military mainly uses deep frozen (-80°C) blood products to support operational medical care. Thawed red cells can be stored for 14 days at 4°C, and are directly available for transfusion, whereas -80°C (refrozen from thawed -30°C) AB FFP must be thawed first for 30-40 min.The possibility of extending the shelf life of this thawed
... lasma to make both products directly available for damage control resuscitation in trauma patients with (massive) blood loss was studied. Methods: Apheresis leukodepleted AB plasma (n = 42) were frozen at -30°C, quarantined, and released after repeated donor testing. On average, units contain 296 ±14 ml of plasma and have been stored at -30°C for 316 ±20 days.The units were thawed in a water bath at 37°C (Type 2032, Forma Scientific) repacked, frozen, and stored as deep frozen plasma (DFP) at -80°C for 20-40 days, before the final thawing procedure. Each day, before sampling, the units were inspected visually. Samples were drawn into sample pouches using sterile techniques, after thawing from -30°C (Day minus 1), from -80°C (Day 0), and after storage for 5,7, and 14 days at 4°C respectively. Samples were immediately processed and APTT, PT, INR, fibrinogen, FV, FVII and FVIII were measured within 4 hours, using an automated coagulation analyzer (Destiny Amelung plus, Trinity Biotech). Results: Apart from a slight prolongation of the APTT, no significant changes were observed when plasma was refrozen and thawed from -80°C. During subsequent storage at 4°C, only the activity of FVII remained stable. Fibrinogen decreased after 14 days of storage, whereas Factor V and VIII decreased after only 5 days of storage. There was no significant difference between 5 or 7 days 4°C stored units. The appearance of the majority of the thawed DFP units changed after 7-14 days storage at 4°C from clear into more turbid solutions, and sometimes even with clots. Conclusions: All units contained more than 50 IU/dL FV, FVII, FVIII on Day 7 and had a normal APTT, PT, INR and fibrinogen concentration. In May 2009, a maximum storage time of seven days at 4°C of-80°C refrozen AB plasma was implemented, making this thawed plasma readily available together with thawed red cells for damage control resuscitation in combat casualties.