Related Experiment Video
Updated: Dec 9, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Whole Blood is Superior to Component Transfusion for Injured Children: A Propensity Matched Analysis
Christine M Leeper1, Mark H Yazer, Darrell J Triulzi
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Insights
Low-titer group O negative whole blood transfusion in pediatric trauma patients is safe and effective, leading to faster shock resolution and reduced component use compared to conventional methods.
Area of Science:
- Pediatric Trauma Care
- Emergency Medicine
- Transfusion Medicine
Background:
- Whole blood transfusion in pediatric trauma is feasible and safe, but its effectiveness requires evaluation.
- Conventional treatment involves component therapy, which may not be as efficient in initial resuscitation.
Purpose of the Study:
- To compare the effectiveness of low-titer group O negative whole blood versus conventional blood component transfusion in injured children.
- To evaluate outcomes such as shock resolution and product volumes transfused.
Main Methods:
- A propensity-matched cohort study comparing pediatric trauma patients (≥1 year) receiving whole blood to those receiving component transfusion.
- Matching criteria included age, hypotension, traumatic brain injury, injury mechanism, and need for emergent surgery.
- Outcomes assessed were time to base deficit resolution, product volumes, and post-transfusion INR.
Main Results:
- Whole blood recipients showed faster resolution of base deficit (2 vs. 6 hours) and lower post-transfusion INR (1.4 vs. 1.6).
- Lower volumes of plasma and platelets were transfused in the whole blood group.
- No significant differences were observed in in-hospital mortality, length of stay, or ventilator days.
Conclusions:
- Whole blood transfusion in pediatric trauma is associated with faster shock resolution and reduced component product transfusion.
- Further research with larger cohorts is needed to confirm these findings and support widespread adoption.
Objective:
To compare a propensity-matched cohort of injured children receiving conventional blood component transfusion to injured children receiving low-titer group O negative whole blood.
Summary Of Background Data:
Transfusion of whole blood in pediatric trauma patients is feasible and safe. Effectiveness has not been evaluated.
Methods:
Injured children ≥1 years old can receive up to 40 mL/kg of cold-stored, uncrossmatched whole blood during initial hemostatic resuscitation. Whole blood recipients (2016-2019) were compared to a propensity-matched cohort who received at least 1 uncrossmatched red blood cell unit in the trauma bay (2013-2016). Cohorts were matched for age, hypotension, traumatic brain injury, injury mechanism, and need for emergent surgery. Outcomes included time to resolution of base deficit, product volumes transfused, and INR after resuscitation.
Results:
Twenty-eight children who received whole blood were matched to 28 children who received components. The whole blood group had faster time to resolution of base deficit [median (IQR) 2 (1-2.5) hours vs 6 (2-24) hours, respectively; P < 0.001]. The post-transfusion INR was decreased in whole blood vs component cohort [median (IQR) 1.4 (1.3-1.5) vs 1.6 (1.4-2.2); P = 0.01]. Lower plasma volumes [median (IQR) = 5 (0-15) mL/kg vs 11 (5-35) mL/kg; P = 0.04] and lower platelet volumes [median (IQR) = 0 (0-2) vs 3 (0-8); P = 0.03] were administered to the whole blood group versus component group. Other clinical variables (in-hospital death, hospital length of stay, intensive care unit length of stay, and ventilator days) did not differ between groups.
Conclusions:
Compared to component transfusion, whole blood transfusion results in faster resolution of shock, lower post-transfusion INR, and decreased component product transfusion. Larger cohorts are required to support these findings.
Related Concept Videos
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:28Kidney Transplant I: Introduction