Impact of whole blood usage in massive transfusion

A retrospective survey comparing blood and component usage during thoracoabdominal aortic reconstruction between patients receiving whole blood vs packed red cells was conducted. Volume of salvaged blood, usage of homologous blood components, and total homologous exposures were compared between eight patients who received only packed red blood cells and four patients who received whole blood for replacement of surgical losses, using a chi-square test for comparison. All variables demonstrated a decline among patients who received whole blood. The declines in homologous blood and plasma usage were statistically significant (P less than .05). The decline in platelet usage did not reach statistical significance. The decline in total homologous exposures approached statistical significance (P less than .1). The data suggest that use of whole blood for expected massive transfusion may reduce total blood-component requirements and total homologous exposures.