Whole blood administration within USCENTCOM

Andrew B. Hall*, Iram Qureshi, Ramey Wilson, Stacy Shackelford, Leron B. King, Joshua Kuper, Jeffrey Timby, Kirby Gross, Sylvain Cardin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Blood product use by the U.S. military has evolved during the conflicts in the U.S. Central Command's area of responsibility to become the preferred resuscitative fluid for damage control procedures. This study evaluates the transition to a whole blood-based trauma system over the past 5 years. Methods: Patients who received blood product transfusion within USCENTCOM between January 1, 2017, and December 31, 2021, were identified from the Medical Situational Awareness in Theater (MSAT) blood reports. Transfusion recipients were categorized as recipients of whole blood only, component therapy only, or mixed therapy. The type of transfusions, number of recipients, number of available blood products were compared over the 5-year period. Results: A total of 1762 unique patients were included. Of this population, 220 (12.5%) received whole blood only, 1196 (68.9%) received component therapy, and 346 (19.6%) received mixed therapy. The monthly proportion of individuals receiving whole blood (only or mixed) significantly increased over the 5-year period (p <.0001). The number of individuals requiring transfusions over this same period decreased significantly (p <.0001). Individuals receiving component therapy (only or mixed) were transfused component platelets 15.7% of the time. The mean and median number of units required per patient receiving whole blood was 2.39 and 1 unit of blood respectively (IQR 1.0–2.5). Conclusion: Whole blood use increased significantly within USCENTCOM's AOR secondary to increased supply and low clinical requirement. Without a long-lasting platelet component, component therapy cannot be expected to provide a balanced therapy to casualties in remote locations.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalTrauma (United Kingdom)
Volume26
Issue number2
DOIs
StatePublished - Apr 2024
Externally publishedYes

Keywords

  • Resuscitation
  • blood
  • military

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