Application of prophylactic heated infusion combined with massive blood transfusion in emergency patients with severe trauma

Luo Peifeng

doi:10.3969/j.issn.1674-7151.2025.03.015

Abstract：Objective To investigate the application effect of prophylactic heated infusion combined with massive blood transfusion in emergency patients with severe trauma.Methods The 90 patients with severe trauma admitted to the emergency department of Longyan Second Hospital from January 2023 to December 2024 were selected as research objects,and the patients were divided into control group(45 cases;emergency routine treatment and blood transfusion treatment were given)and observation group(45 cases;preventive heated infusion was implemented on the basis of control group)based on different emergency intervention methods.The coagulation indicators[activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and prothrombin time(PT)],alkaline indicators[pH value and blood lactic acid(Lac)],inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)],body temperature,incidence of adverse event and outcomes were compared between the two groups.Results Before treatment,there were no significant differences in PT,FIB,APTT,TT,pH value,Lac,CRP,TNF-α,IL-6 and body temperature between the two groups.After 6 hours of treatment,the PT,APTT and TT in observation group were significantly longer than those in control group,and the level of FIB was significantly higher than that in control group[PT(s):15.43±1.68 vs.13.49±1.69;APTT(s):33.15±3.71 vs.28.96±3.84;TT(s):19.72±1.74 vs.17.26±1.76;FIB(g/L):3.10±0.36 vs.2.43±0.46;all P<0.05].After 6 hours of treatment,the levels of pH value and Lac in observation group were significantly higher than those in control group[pH value:7.29±0.07 vs.7.20±0.08;Lac(mmol/L):2.01±0.31 vs.1.73±0.33;both P<0.05].After 24 hours of treatment,the levels of CRP,TNF-α and IL-6 in observation group were significantly lower than those in control group[CRP(mg/L):21.29±2.25 vs.25.73±2.49;TNF-α(μg/L):19.72±3.16 vs.26.73±3.36;IL-6(ng/L):45.29±6.42 vs.61.93±7.88;all P<0.05].The body temperatures in observation group were significantly higher than those in control group after 1 hour,2 hours and 4 hours of treatment[after 1 hour of treatment(℃):35.93±0.24 vs.35.56±0.23;after 2 hours of treatment(℃):36.29±0.25 vs.35.79±0.28;after 4 hours of treatment(℃):36.42±0.42 vs.36.11±0.41;all P<0.05].The incidence of adverse events and first aid failure rate in observation group were significantly lower than those in control group(incidence of adverse events:8.89%vs.26.67%;first aid failure rate:4.44%vs.17.78%;both P<0.05).Conclusion The application of prophylactic heated infusion combined with massive blood transfusion could improve the coagulation function of patients with severe trauma,thereby regulate the acid-base balance in the body,control the inflammatory reaction,help to maintain the patient's body temperature and reduce the incidence of adverse events and first aid failure rate.