Establishment of NATO Trauma Registry—A Joint Project within the NAT Framework

Erik Fosse
2010 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
more » ... 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.
doi:10.1017/s1049023x0002447x fatcat:bebhr4qn6fhxxfi2mdp6oy4k7u