How shall we transfuse Hippolyta? The same way whether on or off the battlefield

Yazer, Mark H.; Nessen, Shawn C.; Andrew, P.

doi:10.1016/j.ajog.2018.03.023

Cited by 6 publications

(10 citation statements)

References 10 publications

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“…There is great concern about alloimunization with WB . Is this an area that is also tradition versus data based?…”

mentioning

confidence: 99%

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Get ready: whole blood is back and it's good for patients

Holcomb

Jenkins

2018

Transfusion

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“…There is great concern about alloimunization with WB . Is this an area that is also tradition versus data based?…”

mentioning

confidence: 99%

“…For example, only a small minority of female patients of childbearing age are transfused. The risk of alloimunization by transfusing O+ LTWB to a Rh− woman of child bearing age is commonly reported at 22% (3%–30%) and an even smaller risk for her future child . If she is in hemorrhagic shock and requires a laparotomy, her mortality is more than 40%.…”

mentioning

confidence: 99%

Get ready: whole blood is back and it's good for patients

Holcomb

Jenkins

2018

Transfusion

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“…Given that many of the recipients of uncrossmatched erythrocytes are likely to be males, especially in civilian and military trauma situations, 4,5 the administration of D+ erythrocytes to a male recipient that later turns out to be D− is of little consequence. 5 In fact, it is worthwhile to consider the consequences of transfusing a D− female of childbearing potential with D+ erythrocyte-containing products; it is known that the rate of forming anti-D among hospitalized D− recipients of at least one unit of D+ erythrocytes is approximately 22%. [6][7][8] In addition, the probability that a Caucasian female might carry a D+ fetus is approximately 85%, 1 and the rate of fetal demise in a sensitized pregnancy is approximately 4%.…”

Section: Discussionmentioning

confidence: 99%

Transfusion of Uncrossmatched Group O Erythrocyte-containing Products Does Not Interfere with Most ABO Typings

et al. 2020

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Background Group O erythrocytes and/or whole blood are used for urgent transfusions in patients of unknown blood type. This study investigated the impact of transfusing increasing numbers of uncrossmatched type O products on the recipient’s first in-hospital ABO type. Methods This was a retrospective cohort study. Results of the first ABO type obtained in adult, non–type O recipients (i.e., types A, B, AB) after receiving at least one unit of uncrossmatched type O erythrocyte-containing product(s) for any bleeding etiology were analyzed along with the number of uncrossmatched type O erythrocyte-containing products administered in the prehospital and/or in hospital setting before the first type and screen sample was drawn. Results There were 10 institutions that contributed a total of 695 patient records. Among patients who received up to 10 uncrossmatched type O erythrocyte-containing products, the median A antigen agglutination strength in A and AB individuals on forward typing (i.e., testing the recipient’s erythrocytes for A and/or B antigens) was the maximum (4+), whereas the median B antigen agglutination strength among B and AB recipients of up to 10 units was 3 to 4+. The median agglutination strength on the reverse type (i.e., testing the recipient’s plasma for corresponding anti-A and -B antibodies) was very strong, between 3 and 4+, for recipients of up to 10 units of uncrossmatched erythrocyte-containing products. Overall, the ABO type of 665 of 695 (95.7%; 95% CI, 93.9 to 97.0%) of these patients could be accurately determined on the first type and screen sample obtained after transfusion of uncrossmatched type O erythrocyte-containing products. Conclusions The transfusion of smaller quantities of uncrossmatched type O erythrocyte-containing products, in particular up to 10 units, does not usually interfere with determining the recipient’s ABO type. The early collection of a type and screen sample is important. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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“…Only about 8% of the US blood donor population is group O-, making these "universal donor" whole blood units scarce. 24 A number of studies have shown that it is feasible and safe to transfuse Oþ whole blood, however, the risk of alloimmunization remains a concern. 23,25,26 However, only a small number of women of childbearing age are transfused.…”

Section: Whole Bloodmentioning

confidence: 99%

“…Furthermore, the risk of becoming alloimmunized to the D antigen (þ/À blood type) is approximately 22% and the risk is smaller yet for hemolytic disease of the newborn in future pregnancies. 24 In contrast, the mortality rate for patients in hemorrhagic shock who require a laparotomy is 40% and the mortality rate for combat causalities requiring blood transfusion is 16%. 19,24 It is also possible to leukoreduce whole blood, which may decrease the risk of alloimmunization.…”

Section: Whole Bloodmentioning

confidence: 99%

Contemporary resuscitation of hemorrhagic shock: What will the future hold?

Chipman

Jenne

et al. 2020

The American Journal of Surgery

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Resuscitation of the critically ill patient with fluid and blood products is one of the most widespread interventions in medicine. This is especially relevant for trauma patients, as hemorrhagic shock remains the most common cause of preventable death after injury. Consequently, the study of the ideal resuscitative product for patients in shock has become an area of great scientific interest and investigation. Recently, the pendulum has swung towards increased utilization of blood products for resuscitation. However, pathogens, immune reactions and the limited availability of this resource remain a challenge for clinicians. Technologic advances in pathogen reduction and innovations in blood product processing will allow us to increase the safety profile and efficacy of blood products, ultimately to the benefit of patients. The purpose of this article is to review the current state of blood product based resuscitative strategies as well as technologic advancements that may lead to safer resuscitation.

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How shall we transfuse Hippolyta? The same way whether on or off the battlefield

Cited by 6 publications

References 10 publications

Get ready: whole blood is back and it's good for patients

Get ready: whole blood is back and it's good for patients

Transfusion of Uncrossmatched Group O Erythrocyte-containing Products Does Not Interfere with Most ABO Typings

Contemporary resuscitation of hemorrhagic shock: What will the future hold?

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