Page 49 - JSOM Spring 2020

has shown to be safe in trauma resuscitation, its benefit to US 4. Spinella PC, Dunne J, Beilman GJ, et al. Constant challenges and
military forces will not be fully realized until its use become evolution of US military transfusion medicine and blood opera-
more widespread among non-SOF medical personnel in the tions in combat. Transfusion. 2012;52(5):1146–1153.
combat environment. 5. Flosdorf EW, Mudd S. Procedure and apparatus for preservation
in “lyophile” form of serum and other biological substances. J
Immunol. 1935;29(5):389–425.
Study Limitations 6. Schmidt PJ. The plasma wars: a history. Transfusion. 2012;52:
There are several limitations of this study. First, the obser- 2S–4S.
vational nature of our investigation limits the conclusions 7. Harding AJ. A brief history of blood transfusion. Biomed Scien-
that can be drawn. Second, for an encounter to be generated tist. 2005;49(11):1147.
within the DoDTR, casualties must arrive at the forward sur- 8. Rappaport EM. Hepatitis following blood or plasma transfusions:
observations in thirty-three cases. JAMA. 1945;128(13):932–939.
gical team or fixed-facility alive or with ongoing interventions; 9. Sailliol, A, Martinaud, C, Cap, AP, et al. The evolving role of
thus, we do not have data on casualties who may have received lyophilized plasma in remote damage control resuscitation in the
FDP and died on the battlefield. Last, and most important, French A Mmed Forces Health Service. Transfusion. 2013;53:
the data within the registry require accurate documentation 65S–71S.
so casualties in which FDP was administered but without the 10. Kendrick, DB. Blood Program in World War II. Office of the
intervention documented would have been missed. Previous Surgeon General, Department of the Army; 1964.
publications have demonstrated poor data capture in the de- 11. Bougle A, Harrois A, Duranteau J. Resuscitative strategies in
traumatic hemorrhagic shock. Ann Intensive Care. 2013;3(1):1.
ployed setting. 27 12. Solheim BG, Chetty R, Flesland O. Indications for use and
cost-effectiveness of pathogen-reduced ABO-universal plasma.
Curr Opin Hematol. 2008;15(6):612–617.
Conclusions 13. Bux J, Dickhörner D, Scheel E. Quality of freeze-dried (lyo-
We report on 11 cases of FDP use within the registry. With the philized) quarantined single-donor plasma. Transfusion. 2013;53
recent FDA approval of FDP for military use, ongoing surveil- (12):3203–3209.
lance is warranted to optimize its implementation into prehos- 14. Buckley L, Gonzales R. Challenges to producing novel therapies–
dried plasma for use in trauma and critical care. Transfusion.
pital guidelines, training, and doctrine. 2019;59(S1):837–845.
15. Schauer SG, April MD, Naylor JF, et al. A descriptive analysis
Acknowledgments of casualties evacuated from the Africa area of operations. Afr J
We would like to thank the Joint Trauma System Data Analy- Emerg Med. 2018.
sis Branch for their efforts with data acquisition. 16. Schauer SG, Naylor JF, April MD, et al. The first 30 months ex-
perience in the non-doctrinal Operation Inherent Resolve medical
theater. Mil Med. 2018.
Disclosures 17. Schauer SG, Naylor JF, Oliver JJ, et al. An analysis of casualties
The authors have nothing to disclose. presenting to military emergency departments in Iraq and Af-
ghanistan. Am J Emerg Med. 2019;37(1):94–99.
Funding 18. Glenn MA, Martin KD, Monzon D, et al. Implementation of a
We received no funding for this study. combat casualty trauma registry. J Trauma Nurs. 2008;15(4):|
181–184.
19. O’Connell KM, Littleton-Kearney MT, Bridges E, et al. Evaluat-
Disclaimer ing the Joint Theater Trauma Registry as a data source to bench-
Opinions or assertions contained herein are the private views mark casualty care. Mil Med. 2012;177(5):546–552.
of the authors and are not to be construed as official or as 20. Schauer SG, April MD, Hill GJ, et al. Prehospital interventions
reflecting the views of the Department of the Air Force, the performed on pediatric trauma patients in Iraq and Afghanistan.
Department of the Army, or the Department of Defense. Prehosp Emerg Care. 2018:1–6.
21. Schauer SG, Hill GJ, Naylor JF, et al. Emergency department re-
suscitation of pediatric trauma patients in Iraq and Afghanistan.
Author Contributions Am J Emerg Med. 2018.
CMC performed the data interpretation and manuscript draft- 22. Schauer SG, Naylor JF, Oliver JJ, et al. An analysis of casualties
ing/development. GC performed data interpretation and man- presenting to military emergency departments in Iraq and Af-
uscript development. SGS is the principal investigator for the ghanistan. Am J Emerg Med. 2018.
overall study and performed data analysis, data interpretation, 23. Niles SE, McLaughlin DF, Perkins JG, et al. Increased mortality
and critical revisions as the senior author. All authors contrib- associated with the early coagulopathy of trauma in combat ca-
sualties. J Trauma Acute Care Surg. 2008;64(6):1459–1465.
uted significantly to this study. 24. Shuja F, Shults C, Duggan M, et al. Development and testing of
freeze-dried plasma for the treatment of trauma-associated coag-
References ulopathy. J Trauma Acute Care Surg. 2008;65(5):975–985.
1. Eastridge BJ, Mabry RL, Seguin P, et al. Death on the battlefield 25. Martinaud C, Ausset S, Deshayes AV, et al. Use of freeze-dried
(2001–2011): implications for the future of combat casualty care. J plasma in French intensive care unit in Afghanistan. J Trauma
Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–437. Acute Care Surg. 2011;71(6):1761–1765.
2. Shackelford SA, Del Junco DJ, Powell-Dunford N, et al. Associa- 26. Daban JL, de Saint Maurice G, Ausset S. Freeze-dried and secured
tion of prehospital blood product transfusion during medical evac- plasma (FDSP): fast available clotting factors for military opera-
uation of combat casualties in Afghanistan with acute and 30-day tions. Annual Meeting of the American Society Anesthesiologists;
survival. JAMA. 2017;318(16):1581–1591. Orlando, FL: 2010.
3. Holcomb JB, Jenkins D, Rhee P, et al. Damage control resusci- 27. Robinson JB, Smith MP, Gross KR, et al. Battlefield documenta-
tation: directly addressing the early coagulopathy of trauma. J tion of Tactical Combat Casualty Care in Afghanistan. US Army
Trauma Acute Care Surg. 2007;62(2):307–310. Med Dep J. 2016;(2–16):87–94.

FDP Use Within the DoD Trauma Registry | 45