Noninferior Red Cell Concentrate Quality after Repeated Air Rescue Mission Transport for Prehospital Transfusion

Area of Science:

• Emergency Medicine
• Transfusion Medicine
• Logistics and Supply Chain Management

Background:

• Prehospital transfusion of red cell concentrates (RCCs) is critical for severe hemorrhage and trauma.
• Air ambulance services offer immediate intervention, with established prehospital transfusion in Germany.
• Limited data exists on regulatory-compliant logistics and RCC quality after repeated air rescue missions.

Purpose of the Study:

• To validate regulatory-compliant logistics for RCC transport via air ambulance.
• To assess the product quality of RCCs after repeated air rescue missions.
• To analyze biochemical parameters and red blood cell (RBC) morphology.

Main Methods:

• A rotation system (1 day transport, 2 days storage) was adapted for RCCs.
• RCCs on air rescue missions (flight group) were compared to a control group.
• Biochemical parameters (hemoglobin, hematocrit, free hemoglobin, hemolysis, potassium, pH) and RBC morphology were assessed.

Main Results:

• 81 RCCs in the flight group and 50 in the control group were assessed.
• RCCs were dispatched an average of 11 times, with an average flight time of 18.3 hours.
• Biochemical and morphological quality parameters remained unchanged after repeated missions, adhering to +2 to +6°C storage conditions.

Conclusions:

• RCC quality after repeated air rescue missions is noninferior to controls.
• Product quality remains within German regulations for up to 42 days.
• The implemented logistics and thermal condition maintenance are safe, feasible, and support life-saving prehospital transfusions.