02250nas a2200205   4500008004100000245011200041210006900153260001800222300001400240490000700254520160800261653001301869653002701882653002201909653001101931100003001942700000501972700003101977856003602008       2024                        eng d00aSuccessful Practice of Massive Transfusion in Traumatic Amputation of Digit I-V Manus Dextra: A Case Report0 aSuccessful Practice of Massive Transfusion in Traumatic Amputati  cDecember 2024  a1436-14380 v163 a<p class="rtejustify">Introduction: Massive blood is the main cause of mortality and morbidity in trauma patients, in which 6 out of 10 cases are reported to die. Case presentation: A 29-year-old man appears to have experienced an amputation of digit I-V manus dextra. Vital signs are in stable condition and the patient is also conscious (GCS of 15) with ASA PS 1. The patient underwent debridement and replantation for 18 hours. Post-first surgery, we found blood seepage in the surgical wound, which for 4 hours showed 2000 mL of blood. The patient experiences decreased consciousness (GCS of 9), hypotension (77/40 mmHg), HR of 130 ×/min, and cold extremities. The patient received resuscitation with 1000 mL of crystalloid, 500 mL of colloid, 800 mL of WB, and 400 mL of PRC transfusion. Abnormal laboratory examination revealed Hb 4.6 g/dL, albumin 1.4 g/dL, and prolongation of hemostasis function 2 times. The patient underwent reoperation and was found to have ruptured muscles and veins for which musculorraphy and venorraphy were performed for 16 hours. On the 3rd day, the patient experienced breathing difficulties (RR of 30 ×/ min and SO<sub>2</sub> of 95%) and the chest x-ray showed lung edema. The patient was placed on a ventilator using NIV and furosemide 20 mg/8 h. The patient regained consciousness on the 7th day. Discussion: The principle of managing massive bleeding is to stop the bleeding, restore blood circulation volume, and maintain peripheral vascularization. Conclusion: Massive transfusion is a management strategy for preventing death due to hemorrhagic shock.</p>
10aBleeding10aBlood massive protocol10aHemorrhagic shock10aTrauma1 aJuwono, Kashi, Ameta Resi1 a1 aAirlangga, Prananda, Surya  uhttps://phcogj.com/article/2448