Efficacy and safety of lyophilized plasma in prehospital emergency care for victims of accidents: a literature review

Relevance . Emergency accidents of natural and technogenic nature, including maritime accidents, are often characterized by significant sanitary losses and various injuries, frequently involving with acute massive blood loss. In emergency situations the latter is a leading cause of death in severely injured patients, often leading to the development of hypocoagulation. To address hypocoagulation, medications and blood components, including lyophilized (freeze–dried) plasma, are utilized. However, current data regarding the effectiveness and safety of such emergency medical care in pre–hospital settings remain contradictory. The objective is to conduct an analytical review to evaluate the effectiveness and safety of lyophilized plasma the clinical setting of prehospital emergency medical care provided to victims of emergency accidents. Methods . The research used scientific publications from open access databases (eLibrary.ru, PubMed). The studies based on registered controlled clinical trials were analyzed to evaluate the efficacy and safety of lyophilized plasma administered in prehospital emergency settings. In addition, we investigated annual reports on posttransfusion reactions and complications, available in international and national blood safety surveillance systems. Results and discussion. The analysis of randomized clinical trials and results did not reveal statistically significant differences in clinical outcomes, complication rates, or severity of coagulopathy in patients receiving lyophilized plasma in prehospital emergency medical care for injuries and wounds in peacetime, in comparison with patients receiving standard treatment. However, available observational studies suggest that lyophilized plasma can effectively used in patients with injuries and bleeding in prehospital emergency care, including during ground and air medical evacuation. Reports of posttransfusion reactions and complications associated with lyophilized plasma transfusion remain incompletely accounted for and are characterized by a low degree of evidence. Conclusion . The results of clinical studies support the feasibility of using lyophilized plasma in adult patients at risk of post–traumatic coagulopathy at the pre–hospital stage of emergency medical care in peacetime. Nonetheless, comprehensive evaluation of the efficacy and safety of lyophilized plasma administration in such patients requires further randomized clinical trials, involving different patient cohorts in various emergency scenarios.