[Verified Answer]: A 31-year-old man presents with a gunshot…

A 31-year-old man presents with a gunshot wound to the abdomen. His heart rate is 130 beats per minute and blood pressure is 90/75 mm Hg. His abdomen is diffusely tender. The patient is taken to the OR for an emergency exploratory laparotomy. During the operation, bleeding from a shattered right kidney is identified. He undergoes a right nephrectomy. During the operation, he receives 6 units of packed red blood cells (PRBCs), 6 units of fresh frozen plasma, and 10 units of platelets. Following control of all bleeding, the patient is taken to the ICU. At the time of his arrival to the ICU, his blood pressure is 110/80 mm Hg and heart rate is 96 beats per minute. The ICU admission laboratory studies reveal a hemoglobin value of 7 g/dL and hematocrit of 29%. The serum lactate was 14 mmol/L (normal range: 0.6-2.1 mmol/L) during the operation and is 1.9 mmol/L at the time of arrival to ICU. Which of the following is the best treatment option at this time? Immediately return the patient to the OR for ongoing bleeding Observe the patient and repeat the serum lactate value and complete blood count (CBC) in 4 hours Transfuse 5 additional units of PRBCs to achieve a hemoglobin value greater than 12 g/dL Perform a CT scan to look for bleeding Transfuse 4 units of PRBCs and schedule abdominal re-exploration