Alternative Plasma Thawers for Austere Resuscitative Surgical Teams: Literature Review

The purpose of this literature review is to identify optimal alternative fresh frozen plasma thawing devices for Austere Resuscitative and Surgical Care (ARSC) teams operating in far forward settings constrained by logistical and operational requirements.

The authors reviewed existing literature to identify optimal alternative plasma thawing devices and assessed power consumption, weight, durability, portability, post-thaw coagulation preservation, and thaw kinetics. Field-adapted plasma thawers and other commercially available plasma thawing systems were analyzed to determine their suitability to meet the needs of ARSC teams. Sixteen articles were included after evaluating methodological quality and strength of evidence.

The authors recommend that ARSC teams use whole blood, liquid plasma, and FDA-approved thawing devices whenever available. However, if these options are not feasible, alternative methods should be considered to meet mission requirements. Among the devices reviewed, the sous vide demonstrated potential for this application. They are lightweight, compact, versatile, and capable of creating target temperature-controlled circulating water baths, making them superior when compared to other identified field-adapted devices. Dry-based thawing systems, such as the ZipThaw®, may also offer advantages by conserving resources like water and electricity; however, further research is needed to validate its effectiveness in forward operating environments.