Open AccessForgot calcium? Admission ionized-calcium in two civilian randomized controlled trials of prehospital plasma for traumatic hemorrhagic shock
Author(s) -
Hunter B. Moore,
Matthew T. Tessmer,
Ernest E. Moore,
Jason L. Sperry,
Mitchell J. Cohen,
Michael P. Chapman,
Anthony E. Pusateri,
Francis X Guyette,
Joshua B. Brown,
Matthew D. Neal,
Brian S. Zuckerbraun,
Angela Sauaia
Publication year - 2020
Publication title -
the journal of trauma and acute care surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.25
H-Index - 187
eISSN - 2163-0763
pISSN - 2163-0755
DOI - 10.1097/ta.0000000000002614
Subject(s) - interquartile range , medicine , hazard ratio , confidence interval , randomized controlled trial , blunt trauma , calcium , injury severity score , shock (circulatory) , calcium metabolism , anesthesia , surgery , emergency medicine , poison control , injury prevention
Randomized clinical trials (RCTs) support the use of prehospital plasma in traumatic hemorrhagic shock, especially in long transports. The citrate added to plasma binds with calcium, yet most prehospital trauma protocols have no guidelines for calcium replacement. We reviewed the experience of two recent prehospital plasma RCTs regarding admission ionized-calcium (i-Ca) blood levels and its impact on survival. We hypothesized that prehospital plasma is associated with hypocalcemia, which in turn is associated with lower survival.