Large volume transfusion with whole blood is safe compared with component therapy

Area of Science:

• Trauma Resuscitation
• Blood Transfusion Medicine
• Emergency Medicine

Background:

• Cold-stored, low-titer group O whole blood (WB) transfusion in civilian trauma has been explored in limited volumes.
• This study is the first to analyze the safety and efficacy of large-volume WB transfusions in trauma patients.

Purpose of the Study:

• To evaluate the safety and efficacy of large-volume whole blood transfusion in civilian trauma patients.
• To compare outcomes between patients receiving component therapy versus component therapy plus whole blood.

Main Methods:

• Retrospective cohort analysis comparing trauma patients resuscitated with component therapy (COMP) versus COMP plus WB.
• Included patients activated the massive transfusion protocol and received at least one unit of WB or RBCs within 24 hours of admission.
• Bivariate analysis was used to compare groups, with one unit of WB equated to one unit of RBCs, one unit of plasma, and 1/6 unit of platelets.

Main Results:

• Forty-two patients received WB and 83 received COMP, with similar baseline characteristics.
• No significant differences in 24-hour or 30-day mortality were observed between the WB and COMP groups.
• The WB group received a higher plasma/RBC ratio (0.94:1 vs. 0.8:1) and experienced no transfusion reactions.

Conclusions:

• Large-volume whole blood transfusion in civilian trauma is feasible and safe.
• Whole blood transfusion appears to be an effective addition to component therapy, potentially leading to more balanced resuscitation.
• This approach may result in increased overall product utilization.