Capillary Lactate and Transfusion Needs

Study Overview
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Brief Summary
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13% of injured normotensive patients arriving in emergency unit need mass blood-transfusion of six or more units of packed Red Blood Cells. It is currently difficult to predict the need for such a mass blood-transfusion. Indeed hemoglobin point of care testing (hemocue) and blood pressure can be normal during the first hours despite intensive bleeding. It's well known that blood or arterial lactate measures correlate with trauma severity but these measures are not available in a pre-hospital setting. The investigators want to test whether capillary lactate measures also correlate with trauma severity and can therefore predicts earlier transfusion needs.

Official Title
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Predictive Abilities for Transfusion Needs of Capillary Lactate Measure in Emergency for Injured Normotensive Patients

Conditions
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Trauma

Intervention / Treatment
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* Other: Capillary lactate level


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult admitted in vital emergency unit Severe trauma normotensive (Systolic Blood Pressure >90mmHg) patient subjected to capillary haemoglobin and glucose measurements patient beneficiary of social security Exclusion Criteria: pregnant woman liver deficiency pre-hospital transfusion hypothermia below 35°C protected persons according to the law Nor epinephrine > 0.1gamma/kg/min

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Injured patient admitted in vital emergency unit<br> | Other: Capillary lactate level<br>* Use of capillary sample to determine lactate level upon arrival at vital emergency unit and at 2 hours<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Transfusion of 6 or more units of packed Red Blood Cells (RBC) |  | 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| arterial lactate measures |  | upon arrival at the vital emergency unit | 
| injury scores (ISS,SOFA) |  | 24h | 
| transfusion of 4 units of packed RBC |  | 48 hours | 
| blood lactate measure |  | upon arrival at vital emergency unit | 
| Intensity of medical care | Body scan Central venous catheterisation arterial catheterisation | upon arrival at vital emergency unit | 
| Bleeding Predictive Score | 3 questions are asked to the doctor in emergency room. Could patient be admitted directly at the CT scan ? Do you think that the patient need transfusion ? If Yes : and how many units ? Do you think that the patient will be hospitalized in an intensive care unit after the emergency room? | upon arrival at vital emergency unit | 
| Mortality |  | 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adults admitted in vital emergency unit