Fresh whole blood use by forward surgical teams in <scp>A</scp>fghanistan is associated with improved survival compared to component therapy without platelets

Nessen, Shawn C.; Eastridge, Brian J.; Cronk, Daniel R.; Craig, Robert M.; Berséus, Olle; Ellison, Richard T.; Remick, Kyle N.; Seery, Jason M.; Shah, Avani; Spinella, Philip C.

doi:10.1111/trf.12044

Cited by 219 publications

(179 citation statements)

References 33 publications

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“…28,29 We found that patients who received transfusion of blood components were 3 times more likely to die than were patients who received whole blood after trauma, regardless of injury severity (OR, 3.164; 95% CI, 1.314-7.618). 30 Only recently have investigators performed a randomized controlled trial to compare transfusion of fresh whole blood with transfusion of blood components.…”

Section: Transfusion Of Blood Components and Potential Consequencesmentioning

confidence: 90%

Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model

Jones

Frazier

2017

Critical Care Nurse

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Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. Although some evidence supports a detrimental association between transfusion and a patient’s outcome, the mechanisms connecting transfusion of stored components to outcomes remain unclear. The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients’ outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days). Complete understanding of these clinical implications is critical for practitioners in evaluating and treating patients given transfusions after traumatic injury.

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Section: Transfusion Of Blood Components and Potential Consequencesmentioning

confidence: 90%

Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model

Jones

Frazier

2017

Critical Care Nurse

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“…[4] FWB is more concentrated than blood products prepared with a 1:1:1 ratio of RBCs, frozen plasma, and platelets, and is the only functional alternative that includes all fractions. Nessen et al [5] evaluated the therapeutic role of additional FWB treatment in patients who required platelet replacement after having received RBCs and FFP. It was concluded that administration of FWB increased survival.…”

Section: Discussionmentioning

confidence: 99%

Should warm fresh whole blood be first choice in acute massive hemorrhage in emergency conditions?

Kendigelen¹,

Kamalak²,

Abat³

2015

Ulus Travma Acil Cerrahi Derg

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Early management of rapid massive hemorrhage requires early administration of blood products and rapid surgical control of bleeding. Professionals in peripheral hospitals with limited resources often work under conditions similar to those in the military. Described in the present report are 3 cases in which warm fresh whole blood (WFWB) was used in patients with massive bleeding who presented to a peripheral hospital that had no blood products suitable for emergency conditions. Described first is the case of a 16-year-old female patient who underwent emergency cesarean section. The patient had massive bleeding from the uterus due to atony. Her hemoglobin (Hb) dropped to 3.5 g/dL. Six units of WFWB were transfused during surgery. Hemodynamic parameters and complete blood count (CBC) stabilized. She was transferred from the intensive care unit (ICU) to obstetrics on day 2 and was discharged on day 7. Described second is the case of a 35-year-old female patient who also underwent emergency cesarean section, and for whom massive bleeding was due to uterine atony. Hb dropped to 2 g/dL and hematocrit (HCT) to 5.4%. Nine units of WFWB were transfused, after which hemodynamic and laboratory parameters stabilized. The patient was extubated the following day, transferred from the ICU to obstetrics on day 3, and was discharged on day 8. Described third is the case of a 36-year-old male patient with stab injuries and hemorrhagic shock who underwent emergency surgery. The patient had injuries to the right renal artery and kidney. Nine units of WFWB were transfused due to continued hemorrhage during surgery. Following surgical control of bleeding and transfusion, hemodynamic parameters improved. The patient was transferred from the ICU on day 5 and discharged on day 10. WFWB transfusion nearly disappeared from civilian medicine after blood was separated into components, and whole blood is not usually available at blood banks. In massive transfusions, WFWB effectively replaces red blood cells (RBCs), platelets, plasma volume, and coagulation factors, while preventing hypothermia and dilutional coagulopathy. Blood components go through biochemical, biomechanical, and immunological changes during long storage, the duration of which affects both transfusion efficacy and associated risks. In the future, with the use of fast donor tests, fast ABO compatibility tests, platelet-sparing leukocyte filters, and developments in pathogen-decreasing technology, fresh whole blood (FWB) may be the first choice for massive transfusion. Future studies will reveal new procedures.

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“…Точно так же, Nessen и др. нашли, что трансфузия СЦК была независимым предиктором выживания у раненных в бою (~ 90%-ое сокращение вероятности летальности), по сравнению с теми раненными, которые неоднократно получали компоненты крови, несмотря на более высокую оценку по ISS, и более низкое АД [50]. После поправки на возраст, пол, и на действие другого средства, те пациенты, которым переливали компо-ненты крови, в 3.2 раза более вероятно умрут при сравнении с пациент ами, которые получили СЦК (OR 3.164, 95%-ый CI 1.314 -7.618, p = 0.010) по данным Jones и др.…”

Section: влияние трансфузий сцк или кк на смертностьunclassified

“…У раненных пациентов, которые получали СЦК, была увеличена в два раза вероятность 30-дневного выживания по сравнению с паци-ент ами, которые получали компоненты крови (OR 2.15, 95% CI 1.21-3.8, p = 0.016). Кроме того, в нескольких рет ро спек-тивных исследованиях показано ассоциа-цию с улучшенным выживанием, при использовании СЦК у больных, которым применяли damage -конт роль в го спи-талях [50].…”

Section: Review P P P a A A I I I N N N A A A N N N A A A E E Eunclassified

Application of fresh whole blood for resuscitation with massive blood loss

Глумчер¹

2017

БЗІТ

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Fresh whole blood use by forward surgical teams in Afghanistan is associated with improved survival compared to component therapy without platelets

Cited by 219 publications

References 33 publications

Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model

Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model

Should warm fresh whole blood be first choice in acute massive hemorrhage in emergency conditions?

Application of fresh whole blood for resuscitation with massive blood loss

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