TY - JOUR
T1 - The use of fresh whole blood in massive transfusion
AU - Repine, Thomas B.
AU - Perkins, Jeremy G.
AU - Kauvar, David S.
AU - Blackborne, Lorne
PY - 2006/6
Y1 - 2006/6
N2 - BACKGROUND: Most indications for whole blood transfusion are now well managed exclusively with blood component therapy, yet the use of fresh whole blood for resuscitating combat casualties has persisted in the U.S. military. METHODS: Published descriptions of whole blood use in military and civilian settings were compared with use of whole blood at the 31st Combat Support Hospital (31st CSH) stationed in Baghdad in 2004-2005. FINDINGS: Concerns about logistics, safety, and relative efficacy of whole blood versus component therapy have argued against the use of whole blood in most settings. However, military physicians have observed some distinct advantages in fresh warm whole blood over component therapy during the massive resuscitation of acidotic, hypothermic, and coagulopathic trauma patients. In this critical role, fresh whole blood was eventually incorporated as an adjunct into a novel whole-blood-based massive transfusion protocol. CONCLUSIONS: Under extreme and austere circumstances, the risk:benefit ratio of whole blood transfusion favors its use. Fresh whole blood may, at times, be advantageous even when conventional component therapy is available.
AB - BACKGROUND: Most indications for whole blood transfusion are now well managed exclusively with blood component therapy, yet the use of fresh whole blood for resuscitating combat casualties has persisted in the U.S. military. METHODS: Published descriptions of whole blood use in military and civilian settings were compared with use of whole blood at the 31st Combat Support Hospital (31st CSH) stationed in Baghdad in 2004-2005. FINDINGS: Concerns about logistics, safety, and relative efficacy of whole blood versus component therapy have argued against the use of whole blood in most settings. However, military physicians have observed some distinct advantages in fresh warm whole blood over component therapy during the massive resuscitation of acidotic, hypothermic, and coagulopathic trauma patients. In this critical role, fresh whole blood was eventually incorporated as an adjunct into a novel whole-blood-based massive transfusion protocol. CONCLUSIONS: Under extreme and austere circumstances, the risk:benefit ratio of whole blood transfusion favors its use. Fresh whole blood may, at times, be advantageous even when conventional component therapy is available.
KW - Blood banking
KW - Combat casualty care
KW - Fresh whole blood
KW - Massive transfusion
KW - Trauma
KW - Walking blood bank
UR - http://www.scopus.com/inward/record.url?scp=33745157157&partnerID=8YFLogxK
U2 - 10.1097/01.ta.0000219013.64168.b2
DO - 10.1097/01.ta.0000219013.64168.b2
M3 - Article
C2 - 16763483
AN - SCOPUS:33745157157
SN - 0022-5282
VL - 60
SP - S59-S66
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 6 SUPPL.
ER -