A Scoping Review of Promising Alternative Blood Products for Prolonged Field Care

Hemorrhage is the leading cause of potentially preventable death on the battlefield. Blood transfusions are used as treatment to restore circulating volume until the hemorrhage can be surgically controlled. Research has shown earlier transfusion of blood products has better casualty outcomes, so blood products have been pushed forward to the point of injury. Currently, there is a mixed use of blood components and whole blood in the prehospital setting-both of which have challenging supply chain requirements. Alternative blood products offer several potential advantages, as they are easier to mass produce, obviating the need for donor recruitment. They also have improved shelf-life stability, potentially remove cold-chain storage, and even cross-matching requirements. In this limited review, we sought to provide a narrative review of current promising developments including hemoglobin-based oxygen carriers, polyhemoglobin, platelet like cells, dried plasma, liquid plasma, fibrinogen concentrates, enzyme concentrates, nanoparticles, and perfluorocarbon-based artificial oxygen carriers.