[ { "key": "M6JAGKA4", "version": 24, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/M6JAGKA4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/M6JAGKA4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } }, "creatorSummary": "Weinberg et al.", "parsedDate": "2010-12", "numChildren": 1 }, "data": { "key": "M6JAGKA4", "version": 24, "itemType": "journalArticle", "title": "Duration of red cell storage influences mortality after trauma", "creators": [ { "creatorType": "author", "firstName": "Jordan A.", "lastName": "Weinberg" }, { "creatorType": "author", "firstName": "Gerald", "lastName": "McGwin" }, { "creatorType": "author", "firstName": "Marianne J.", "lastName": "Vandromme" }, { "creatorType": "author", "firstName": "Marisa B.", "lastName": "Marques" }, { "creatorType": "author", "firstName": "Sherry M.", "lastName": "Melton" }, { "creatorType": "author", "firstName": "Donald A.", "lastName": "Reiff" }, { "creatorType": "author", "firstName": "Jeffrey D.", "lastName": "Kerby" }, { "creatorType": "author", "firstName": "Loring W.", "lastName": "Rue" } ], "abstractNote": "BACKGROUND: Although previous studies have identified an association between the transfusion of relatively older red blood cells (RBCs) (storage ≥ 14 days) and adverse outcomes, they are difficult to interpret because the majority of patients received a combination of old and fresh RBC units. To overcome this limitation, we compared in-hospital mortality among patients who received exclusively old versus fresh RBC units during the first 24 hours of hospitalization.\nMETHODS: Patients admitted to a Level I trauma center between January 2000 and May 2009 who received ≥ 1 unit of exclusively old (≥ 14 days) vs. fresh (< 14 days) RBCs during the first 24 hours of hospitalization were identified. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for the association between mortality and RBC age, adjusted for patient age, Injury Severity Score, gender, receipt of fresh frozen plasma or platelets, RBC volume, brain injury, and injury mechanism (blunt or penetrating).\nRESULTS: One thousand six hundred forty-seven patients met the study inclusion criteria. Among patients who were transfused 1 or 2 RBC units, no difference in mortality with respect to RBC age was identified (adjusted RR, 0.97; 95% CI, 0.72-1.32). Among patients who were transfused 3 or more RBC units, receipt of old versus fresh RBCs was associated with a significantly increased risk of mortality, with an adjusted RR of 1.57 (95% CI, 1.14-2.15). No difference was observed concerning the mean number of old versus fresh units transfused to patients who received 3 or more units (6.05 vs. 5.47, respectively; p = 0.11).\nCONCLUSION: In trauma patients undergoing transfusion of 3 or more RBC units within 24 hour of hospital arrival, receipt of relatively older blood was associated with a significantly increased mortality risk. Reservation of relatively fresh RBC units for the acutely injured may be advisable.", "publicationTitle": "The Journal of Trauma", "publisher": "", "place": "", "date": "Dec 2010", "volume": "69", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "1427-1431; discussion 1431-1432", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Trauma", "DOI": "10.1097/TA.0b013e3181fa0019", "citationKey": "", "url": "", "accessDate": "", "PMID": "21150522", "PMCID": "PMC3136808", "ISSN": "1529-8809", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Blood Preservation", "type": 1 }, { "tag": "Chi-Square Distribution", "type": 1 }, { "tag": "Erythrocyte Transfusion", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hospital Mortality", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Injury Severity Score", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Wounds and Injuries", "type": 1 } ], "collections": [ "SIN57T26" ], "relations": {}, "dateAdded": "2014-11-19T02:46:53Z", "dateModified": "2014-11-19T02:46:53Z" } }, { "key": "CBIU339I", "version": 18, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/CBIU339I", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/CBIU339I", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299275/items/M6JAGKA4", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } } }, "data": { "key": "CBIU339I", "version": 18, "parentItem": "M6JAGKA4", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-11-19T02:46:53Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/21150522", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-11-19T02:46:53Z", "dateModified": "2014-11-19T02:46:53Z" } }, { "key": "6RBSHEZB", "version": 24, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/6RBSHEZB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/6RBSHEZB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } }, "creatorSummary": "Mitra et al.", "parsedDate": "2010-01", "numChildren": 1 }, "data": { "key": "6RBSHEZB", "version": 24, "itemType": "journalArticle", "title": "Fresh frozen plasma (FFP) use during massive blood transfusion in trauma resuscitation", "creators": [ { "creatorType": "author", "firstName": "Biswadev", "lastName": "Mitra" }, { "creatorType": "author", "firstName": "Alfredo", "lastName": "Mori" }, { "creatorType": "author", "firstName": "Peter A.", "lastName": "Cameron" }, { "creatorType": "author", "firstName": "Mark", "lastName": "Fitzgerald" }, { "creatorType": "author", "firstName": "Eldho", "lastName": "Paul" }, { "creatorType": "author", "firstName": "Alison", "lastName": "Street" } ], "abstractNote": "INTRODUCTION: Recent retrospective studies have found high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratios during trauma resuscitation to be associated with improved mortality. Whilst this association may be related to a mortality bias present in these studies, there has been an overall tendency towards a 1:1 FFP:PRBC ratio in massive transfusion guidelines worldwide. The aim of this study was to retrospectively review the administration of FFP in patients undergoing massive transfusion during trauma resuscitation, to add to the evidence base for massive transfusion guidelines.\nMATERIALS AND METHODS: Multi-trauma patients who were administered blood transfusions of 5units or more of packed red blood cells (PRBCs) in the first 4h were included in this study. Mortality was the primary endpoint with length of hospital stay, ICU hours and mechanically ventilated hours secondary endpoints.\nRESULTS: There were 331 patients included in this study with a median Injury Severity Score (ISS) of 36 (25-50) and a mortality of 29.9%. There was little change in the ratio of FFP:PRBC transfused per patient from 2005 to 2008. A low FFP:PRBC ratio in the first 4h of resuscitation, older age, low initial GCS and coagulopathy on presentation were significant independent factors associated with mortality. When deaths in the first 24h were excluded, the FFP:PRBC ratio had no association with mortality.\nDISCUSSION: This study has shown increased initial survival in association with higher FFP:PRBC ratios during massive transfusion in a population with a high proportion of blunt injuries. The association is difficult to interpret because of an inherent survival bias. The optimal ratio of FFP:PRBC during massive transfusion may be different to 1:1 and further prospective research is required. There is now an increasing need for well designed randomised controlled trials to determine the best FFP:PRBC ratio for the resuscitation of blunt multi-trauma patients.", "publicationTitle": "Injury", "publisher": "", "place": "", "date": "Jan 2010", "volume": "41", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "35-39", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Injury", "DOI": "10.1016/j.injury.2009.09.029", "citationKey": "", "url": "", "accessDate": "", "PMID": "19833331", "PMCID": "", "ISSN": "1879-0267", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Blood Coagulation Disorders", "type": 1 }, { "tag": "Blood Component Transfusion", "type": 1 }, { "tag": "Erythrocyte Transfusion", "type": 1 }, { "tag": "Hospital Mortality", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Injury Severity Score", "type": 1 }, { "tag": "Intensive Care", "type": 1 }, { "tag": "Length of Stay", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Multiple Trauma", "type": 1 }, { "tag": "Plasma", "type": 1 }, { "tag": "Respiration, Artificial", "type": 1 }, { "tag": "Resuscitation", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Survival Analysis", "type": 1 }, { "tag": "Trauma Centers", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Wounds, Nonpenetrating", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [ "SIN57T26" ], "relations": {}, "dateAdded": "2014-11-19T02:45:02Z", "dateModified": "2014-11-19T02:45:02Z" } }, { "key": "T6I3F5C5", "version": 17, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/T6I3F5C5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/T6I3F5C5", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299275/items/6RBSHEZB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } } }, "data": { "key": "T6I3F5C5", "version": 17, "parentItem": "6RBSHEZB", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-11-19T02:45:02Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19833331", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-11-19T02:45:02Z", "dateModified": "2014-11-19T02:45:02Z" } }, { "key": "H7VEDBPB", "version": 24, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/H7VEDBPB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/H7VEDBPB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } }, "creatorSummary": "Long et al.", "parsedDate": "2013-08", "numChildren": 1 }, "data": { "key": "H7VEDBPB", "version": 24, "itemType": "journalArticle", "title": "When enough is enough: impact of packed red blood cells in massive transfusion outcomes", "creators": [ { "creatorType": "author", "firstName": "Kira", "lastName": "Long" }, { "creatorType": "author", "firstName": "Jiselle Bock", "lastName": "Heaney" }, { "creatorType": "author", "firstName": "Eric R.", "lastName": "Simms" }, { "creatorType": "author", "firstName": "Norman E.", "lastName": "McSwain" }, { "creatorType": "author", "firstName": "Juan C.", "lastName": "Duchesne" } ], "abstractNote": "Massive transfusion protocol (MTP) with fresh-frozen plasma and packed red blood cells (PRBCs) in a 1:1 ratio is one of the most common resuscitative strategies used in patients with severe hemorrhage. There are no studies to date that examine the best postoperative hematocrit range as a marker for survival after MTP. We hypothesize a postoperative hematocrit dose-dependent survival benefit in patients receiving MTP. This was a 53-month retrospective analysis of patients with intra-abdominal injuries requiring surgery and transfusion of 10 units PRBCs or more at a single Level I trauma center. Groups were defined by postoperative hematocrit (less than 21, 21 to 29, 29.1 to 39, and 39 or more). Kaplan-Meier (KM) survival probability was calculated. One hundred fifty patients requiring operative abdominal explorations and 10 units PRBCs or more were identified. There were no significant differences in demographics between groups. When comparing postoperative hematocrit groups, relative to a hematocrit of less than 21 per cent in KM survival analysis, an overall survival advantage was only evident in patients transfused to hematocrits 29.1 to 39 per cent (P < 0.03; odds ratio [OR], 0.284; 95% confidence interval [CI], 0.089 to 0.914). This survival advantage was not seen in the other groups (21 to 29: OR, 0.352; 95% CI, 0.103 to 1.195 or 39% or greater: OR, 0.107; 95% CI, 0.010 to 1.121). This is the first study to examine the impact of postoperative hematocrit as an indicator of survival after MTP in the trauma patient. Transfusion to hematocrits between 29.1 and 39 per cent conveyed a survival benefit, whereas resuscitation to supraphysiologic hematocrits 39 per cent or greater conveyed no additional survival benefit. This study highlights the need for judicious PRBC administration during MTP and its potential impact on survival in patients with postoperative supraphysiologic hematocrits.", "publicationTitle": "The American Surgeon", "publisher": "", "place": "", "date": "Aug 2013", "volume": "79", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "810-814", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am Surg", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "23896250", "PMCID": "", "ISSN": "1555-9823", "archive": "", "archiveLocation": "", "shortTitle": "When enough is enough", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Abdominal Injuries", "type": 1 }, { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Erythrocyte Transfusion", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hematocrit", "type": 1 }, { "tag": "Hemorrhage", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Kaplan-Meier Estimate", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Plasma", "type": 1 }, { "tag": "Resuscitation", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Survival Rate", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [ "SIN57T26" ], "relations": {}, "dateAdded": "2014-11-19T02:43:05Z", "dateModified": "2014-11-19T02:43:05Z" } }, { "key": "R5MH87RE", "version": 16, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/R5MH87RE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/R5MH87RE", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299275/items/H7VEDBPB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } } }, "data": { "key": "R5MH87RE", "version": 16, "parentItem": "H7VEDBPB", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-11-19T02:43:05Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23896250", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-11-19T02:43:05Z", "dateModified": "2014-11-19T02:43:05Z" } }, { "key": "CV6EBBCQ", "version": 24, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299275/items/CV6EBBCQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/bmc_critical_care_conf_nov2014/items/CV6EBBCQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1161085, "username": "webakerma", "name": "William Baker", "links": { "alternate": { "href": "https://www.zotero.org/webakerma", "type": "text/html" } } }, "creatorSummary": "Valle et al.", "parsedDate": "2014-06", "numChildren": 1 }, "data": { "key": "CV6EBBCQ", "version": 24, "itemType": "journalArticle", "title": "Do all trauma patients benefit from tranexamic acid?", "creators": [ { "creatorType": "author", "firstName": "Evan J.", "lastName": "Valle" }, { "creatorType": "author", "firstName": "Casey J.", "lastName": "Allen" }, { "creatorType": "author", "firstName": "Robert M.", "lastName": "Van Haren" }, { "creatorType": "author", "firstName": "Jassin M.", "lastName": "Jouria" }, { "creatorType": "author", "firstName": "Hua", "lastName": "Li" }, { "creatorType": "author", "firstName": "Alan S.", "lastName": "Livingstone" }, { "creatorType": "author", "firstName": "Nicholas", "lastName": "Namias" }, { "creatorType": "author", "firstName": "Carl I.", "lastName": "Schulman" }, { "creatorType": "author", "firstName": "Kenneth G.", "lastName": "Proctor" } ], "abstractNote": "BACKGROUND: This study tested the hypothesis that early routine use of tranexamic acid (TXA) reduces mortality in a subset of the most critically injured trauma intensive care unit patients.\nMETHODS: Consecutive trauma patients (n = 1,217) who required emergency surgery (OR) and/or transfusions from August 2009 to January 2013 were reviewed. At surgeon discretion, TXA was administered at a median of 97 minutes (1-g bolus then 1-g over 8 hours) to 150 patients deemed high risk for hemorrhagic death. With the use of propensity scores based on age, sex, traumatic brain injury (TBI), mechanism of injury, systolic blood pressure, transfusion requirements, and Injury Severity Score (ISS), these patients were matched to 150 non-TXA patients.\nRESULTS: The study population was 43 years old, 86% male, 54% penetrating mechanism of injury, 25% TBI, 28 ISS, with 22% mortality. OR was required in 78% at 86 minutes, transfusion was required in 97% at 36 minutes, and 75% received both. For TXA versus no TXA, more packed red blood cells and total fluid were required, and mortality was 27% versus 17% (all p < 0.05). The effects of TXA were similar in those with or without TBI, although ISS, fluid, and mortality were all higher in the TBI group. Mortality associated with TXA was influenced by the timing of administration (p < 0.05), but any benefit was eliminated in those who required more than 2,000-mL packed red blood cells, who presented with systolic blood pressure of less than 120 mm Hg or who required OR (all p < 0.05).\nCONCLUSION: For the highest injury acuity patients, TXA was associated with increased, rather than reduced, mortality, no matter what time it was administered. This lack of benefit can probably be attributed to the rapid availability of fluids and emergency OR at this trauma center. Prospective studies are needed to further identify conditions that may override the benefits from TXA.\nLEVEL OF EVIDENCE: Therapeutic study, level IV.", "publicationTitle": "The Journal of Trauma and Acute Care Surgery", "publisher": "", "place": "", "date": "Jun 2014", "volume": "76", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "1373-1378", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Trauma Acute Care Surg", "DOI": "10.1097/TA.0000000000000242", "citationKey": "", "url": "", "accessDate": "", "PMID": "24854303", "PMCID": "", "ISSN": "2163-0763", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Antifibrinolytic Agents", "type": 1 }, { "tag": "Brain Injuries", "type": 1 }, { "tag": "Dose-Response Relationship, Drug", "type": 1 }, { "tag": "Double-Blind Method", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Hemodynamics", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Incidence", "type": 1 }, { "tag": "Injections, Intravenous", "type": 1 }, { "tag": "Injury Severity Score", "type": 1 }, { "tag": "Intracranial Hemorrhage, Traumatic", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Prognosis", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Resuscitation", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "Survival Rate", "type": 1 }, { "tag": "Tranexamic Acid", "type": 1 }, { "tag": "Trauma Centers", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [ "SIN57T26" ], "relations": {}, "dateAdded": "2014-11-19T02:38:06Z", "dateModified": "2014-11-19T02:38:06Z" } }, { "key": "A8FC6FEP", "version": 15, "library": { "type": "group", "id": 299275, "name": "BMC_critical_care_conf_Nov2014", "links": { "alternate": { "href": 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Resuscitative endovascular balloon occlusion of the aorta (REBOA) has demonstrated promise in translational large animal and early clinical series as an effective resuscitation and hemorrhage control adjunct. However, it is unknown what proportion of combat casualties has an injury pattern and clinical course that is amenable to REBOA deployment. The prospective UK Joint Theatre Trauma Registry was used to retrospectively identify all UK military personnel who has sustained a severe combat injury, defined as an Abbreviated Injury Scale of three or greater, in the course of 10 years. Patients were then divided into three groups based on Abbreviated Injury Scale injury pattern: no indications for REBOA, contraindications (mediastinal, cervical, and axillary hemorrhage), and indications (torso and pelvic hemorrhage). From a total of 1,317 patients, 925 (70.2%) had no indication, 148 (11.2%) had a contraindication, and 244 (18.5%) had an indication for REBOA. Within the group with indications for REBOA, there were 174 deaths: 79 at the point of wounding, 66 en route to hospital, and 29 in-hospital deaths. The median (interquartile range) time to death in patients dying en route was 75 (42-109) min, and the median prehospital time for casualties admitted to hospital was 61 (34-89) min. One-in-five severely injured UK combat casualties have a focus of hemorrhage in the abdomen or pelvic junctional region potentially amenable to REBOA deployment. 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