Whole Blood Requirements in Civilian Trauma Resuscitation: Implications for Blood Inventory Program

Area of Science:

• Trauma Surgery
• Transfusion Medicine
• Emergency Medicine

Background:

• Determining adequate whole blood (WB) inventory for trauma centers is challenging.
• The study utilized the military's whole blood equivalent (WBE) concept to assess WB needs.

Purpose of the Study:

• To determine current whole blood (WB) requirements using whole blood equivalent (WBE) across diverse trauma center levels.
• To inform inventory management strategies for trauma centers implementing WB programs.

Main Methods:

• Retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database (2017-2018).
• Included adult trauma patients (≥16 years) who received massive transfusions.
• Calculated WBE as WB units plus equivalent component product units (RBC + FFP + 0.2 platelets).

Main Results:

• Analyzed 9976 patients; mean age 41, 77.8% male.
• Median 24-hour WBE transfusion was 10 units.
• 75% of patients required ≤14 WBE units, 90% required ≤17 WBE units.
• No significant difference in median WBE transfusions across trauma center levels (P=0.126).

Conclusions:

• Nationwide, 75% of massive transfusion patients received ≤14 WBE units.
• Findings offer critical data for trauma centers to optimize WB inventory.
• Supports effective implementation of future whole blood programs.