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US Central Command military blood utilization practices 2011 to 2020.
Andrew B Hall1, Iram Qureshi, Heidi McMinn
1From the US Central Command, Office of the Surgeon General (A.B.H., H.M., J.K.), MacDill AFB, Florida; Naval Medical Research Unit San Antonio (I.Q., S.C.), Combat Casualty Care Directorate, San Antonio, Texas; 1st Medical Battalion (J.M.G.), 1st Marine Logistics Group, Camp Pendleton, California; and US Army Institute of Surgical Research (M.D.T.), Joint Trauma System, San Antonio, Texas.
Whole blood transfusions, including stored whole blood (SWB), significantly increased in military medical care over the last decade. This trend suggests a shift in resuscitation strategies, potentially impacting future blood product requirements.
Area of Science:
- Military Medicine
- Transfusion Medicine
- Trauma Resuscitation
Background:
- US military involvement in Afghanistan concluded in 2021, with declining global casualty rates.
- Understanding blood utilization shifts is crucial for optimizing clinical strategies and future resource planning.
- A review of blood product use was conducted during the final decade of major US conflict engagement.
Purpose of the Study:
- To analyze trends in blood product utilization over the past decade within the US Central Command (CENTCOM) area of responsibility.
- To identify clinical and operational connections between blood use patterns and resuscitation strategy changes.
- To inform future blood product requirements based on historical usage data.
Main Methods:
- Data on blood products transfused from January 1, 2011, to December 31, 2020, were obtained from Medical Situational Awareness in Theater (MSAT) blood reports.
- Blood usage data from the entire US Central Command area of responsibility were queried.
- Statistical analysis, including Kendall's tau-b and Pearson's r correlations, was used to assess trends and relationships.
Main Results:
- Packed red blood cells and fresh frozen plasma (FFP) usage remained statistically unchanged over the study period.
- Utilization of both fresh and stored whole blood (SWB) demonstrated a significant increase over time.
- A notable inverse correlation was observed between stored whole blood (SWB) and FFP usage, as well as liquid plasma and FFP usage.
Conclusions:
- Military medical care saw a significant rise in whole blood utilization, particularly stored whole blood (SWB).
- Component therapy is expected to remain vital for resuscitation during large-scale combat operations due to logistical advantages.
- Shifting transfusion practices necessitate re-evaluation of blood product requirements for modern military medical operations.