The Hemostatic Effect of Transfusing Fresh Whole Blood Versus Platelet Concentrates After Cardiac Operations

The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital

“…32 The platelet contribution from FWB was not included in the calculation of apheresis platelet units transfused, though FWB has previously been shown to be as effective as 10 units of platelet concentrate. 33 The initial 24-hour amount of crystalloid and blood products transfused was also calculated as liters or units per hour. The rate of crystalloid and blood products per hour was calculated to adjust for the amount of crystalloid and blood products transfused to patients who died less than 24 hours from the initiation of the massive transfusion.…”

From Donor to Patient in 20 Minutes

“…Treatment with FWB can reverse dilutional coagulopathy associated with transfusing large amounts of preserved red blood cells. 11 Whole blood and PRBCs differ markedly. Type O whole blood has benefits in correcting coagulopathy that may offset the inherent risks of giving FWB.…”

Fresh Whole Blood Transfusion: A Controversial Military Practice

“…21 Clinically, FWB has been demonstrated to reverse dilutional coagulopathy, with evidence that a single unit of FWB has a hemostatic effect similar to ten units of platelets. 2 The hemostatic efficacy of FWB has been documented in numerous reports describing military, civilian trauma center, and operating room use to treat coagulopathic bleeding. 1,4,8,[22][23][24][25] In a retrospective study of the results of the FWB procedures for one forward-deployed US military hospital in 2004, 87 patients received 545 units.…”

“…Compared with blood components that can be processed, tested, freeze-dried, packaged, stored, shipped, and reconstituted, fresh whole blood was considered to be logistically impractical, wasteful, and unsafe. Military physicians, however, never lost sight of the known benefits of whole blood, [1][2][3][4] and the practice of FWB transfusion from combat hospitals in World War II [5][6][7] continues to this day. Military surgical teams utilize FWB by relying on a "walking blood bank" of soldier donors when blood requirements outpace supplies or when coagulopathic patients require blood products unavailable at their current echelon of care-two conditions that often coincide.…”