Journal ArticleDOI
Impact of Incorporating Whole Blood into Hemorrhagic Shock Resuscitation: Analysis of 1,377 Consecutive Trauma Patients Receiving Emergency-Release Uncrossmatched Blood Products
TLDR
A prospective observational cohort study of injured patients receiving emergency-release blood products was performed in this paper , where the authors investigated survival benefit of WB across a diverse population of bleeding trauma patients.Abstract:
Use of whole blood (WB) for trauma resuscitation has seen a resurgence. The purpose of this study was to investigate survival benefit of WB across a diverse population of bleeding trauma patients.A prospective observational cohort study of injured patients receiving emergency-release blood products was performed. All adult trauma patients resuscitated between November 2017 and September 2020 were included. The WB group included patients receiving any group O WB units. The component (COMP) group received no WB units, instead relying on fractionated blood (red blood cells, plasma, and platelets). Univariate and multivariate analyses were performed. Given large observed differences in our regression model, post hoc adjustments with inverse probability of treatment were conducted and a propensity score created. Propensity scoring and Poisson regression supported these findings.Of 1,377 patients receiving emergency release blood products, 840 received WB and 537 remained in the COMP arm. WB patients had higher Injury Severity Score (ISS; 27 vs 20), lower field blood pressure (103 vs 114), and higher arrival lactate (4.2 vs 3.5; all p < 0.05). Postarrival transfusions and complications were similar between groups, except for sepsis, which was lower in the WB arm (25 vs 30%, p = 0.041). Although univariate analysis noted similar survival between WB and COMP (75 vs 76%), logistic regression found WB was independently associated with a 4-fold increased survival (odds ratio [OR] 4.10, p < 0.001). WB patients also had a 60% reduction in overall transfusions (OR 0.38, 95% CI 0.21-0.70). This impact on survival remained regardless of location of transfusion, ISS, or presence of head injury.In patients experiencing hemorrhagic shock, WB transfusion is associated with both improved survival and decreased overall blood utilization. read more
Citations
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Journal ArticleDOI
Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding
Paddy Ssentongo,Choi, Inhyeok,albertcoin082,Joanna Carroll,François X. Claret,07065086538,Baydjanov Bekzod Xaitboyevich, Turopova Gavxaroy Jamoldin qizi +6 more
TL;DR: In this paper , the authors performed a 14-center, prospective observational study of trauma patients who received WB versus BCT during their resuscitation and found that WB patients were 9% less likely to experience bleeding complications and were 48% fewer likely to die than BCT patients (P < 0.0001).
Journal ArticleDOI
Pediatric traumatic hemorrhagic shock consensus conference research priorities
TL;DR: A panel of 16 consensus multidisciplinary committee members from the Pediatric Traumatic Hemorrhagic Shock Consensus Conference developed research priorities for addressing knowledge gaps in the care of injured children and adolescents in hemorrhagic shock as discussed by the authors .
Journal ArticleDOI
Resuscitation with whole blood or blood components improves survival and lessens the pathophysiological burden of trauma and haemorrhagic shock in a pre-clinical porcine model
TL;DR: In this paper , the authors evaluated the quality of resuscitation afforded by blood/blood products or crystalloid resuscitation over extended 'pre-hospital' timelines in a porcine model of traumatic haemorrhagic shock.
Journal ArticleDOI
An observational study of the blood use in combat casualties of the French Armed Forces, 2013–2021
Nicolas Py,Sandrine Pons,Matthieu Boyé,Thibault Martinez,Sylvain Ausset,Christophe Martinaud,Pierre Pasquier +6 more
TL;DR: The French Armed Forces conduct asymmetric warfare in the Sahara-Sahel Strip as mentioned in this paper , where casualties are treated with damage control resuscitation to the extent possible, and questions remain about the feasibility and sustainability of using blood for wider use in austere environments.
Journal ArticleDOI
Emergency transfusion with whole blood versus packed red blood cells: A study of 1400 patients
TL;DR: In this paper , the initial release of LTOWB compared with packed red blood cells (pRBCs) reduced overall blood requirements for patients needing emergency transfusion, and secondary outcomes examined included survival and non-lethal adverse clinical outcomes.
References
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Coagulopathy and blood component transfusion in trauma
Donat R. Spahn,Rolf Rossaint +1 more
TL;DR: Strategies to prevent significant coagulopathy and to control critical bleeding effectively in the presence of coagULopathy may decrease the requirement for blood transfusion, thereby improving clinical outcome of patients with major trauma.
Journal ArticleDOI
A randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions.
Bryan A. Cotton,Jeanette M. Podbielski,Elizabeth A. Camp,Timothy Welch,Deborah J. del Junco,Yu Bai,Rhonda Hobbs,Jamie Scroggins,Beth Hartwell,Rosemary A. Kozar,Charles E. Wade,John B. Holcomb +11 more
TL;DR: Compared with COMP therapy, WB did not reduce transfusion volumes in severely injured patients predicted to receive massive transfusion, however, in the sensitivity analysis (patients without severe brain injuries), use of mWB significantly reduced transfusions volumes, achieving the prespecified endpoint of this initial pilot study.