Citation

Hamilton JA, Mora AG, Chung KK, Bebarta VS. Shock 2015; 44 Suppl 1: 50-54.

Affiliation

Joshua.A.Hamilton18.mil@mail.mil, Fellow Department of Pulmonary and Critical Care Medicine, San Antonio Uniformed Services Health Education Consortium Air Force Enroute Care Research Center, U. S. Army Institute of Surgical Research United States Army Institue for Surgical Research, Uniformed Health Services University of the Health Sciences Air Force Enroute Care Research Center, U. S. Army Institute of Surgical Research.

Copyright

(Copyright © 2015, The Shock Society, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/SHK.0000000000000336

PMID

25643014

Abstract

Impact of anemia in critically ill burned casualties evacuated from combat theater via US military Critical Care Air Transport Teams BACKGROUND: US military critical care air transport teams (CCATT) transport critically ill burn patients out of theater. Blood transfusion may incur adverse effects and studies report lower hemoglobin (Hgb) value may be safe for critically ill patients. There are no studies evaluating the optimal Hgb value for critically ill burn patients prior to CCATT evacuation.

OBJECTIVE: To determine if critically ill burn casualties with a Hgb≤10g/dL, transported via CCATT, have similar clinical outcomes at 30 days as compared to patients with a Hgb>10g/dL.

METHODS: We conducted an IRB approved, retrospective cohort study involving patients transported via CCATT. We separated our study population into two cohorts based on Hgb levels at the time of theater evacuation: Hgb≤10 or Hgb>10. We compared demographics, injury description, physiologic parameters, and clinical outcomes.

RESULTS: Of the 140 subjects enrolled, 29 were Hgb≤10, and 111 were Hgb>10. Both groups were similar in age and % total body surface area burned. Hgb≤10 had a higher ISS (34±19.8 vs 25±16.9, p=0.02) and were more likely to have additional trauma (50% vs 25%, p=0.04). Modeling revealed no persistent differences in mortality, and other clinical outcomes measured.

CONCLUSION: CCATT transport of critically ill burn patients with a Hgb≤10g/dl, had no significant differences in complications or mortality as compared to patients with a Hgb>10g/dL. In this study, lower hemoglobin levels did not confer greater risk for worse outcomes.

Language: en