The use of fresh whole blood in massive transfusion

Thomas B. Repine*, Jeremy G. Perkins, David S. Kauvar, Lorne Blackborne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

202 Scopus citations


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.

Original languageEnglish
Pages (from-to)S59-S66
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number6 SUPPL.
StatePublished - Jun 2006
Externally publishedYes


  • Blood banking
  • Combat casualty care
  • Fresh whole blood
  • Massive transfusion
  • Trauma
  • Walking blood bank


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