The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma

Kronstedt, Shane; Lee, Joon; Millner, David; Mattivi, Connor; LaFrankie, Halli; Paladino, Lorenzo; Siegler, Jeffrey

doi:10.7759/cureus.24263

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…Безпечність та ефективність переливання цільної донор с ької к р ові з а о с т анні дв а де с я т и лі т т я багаторазово доведено в умовах війни. Практика використання цільної крові у США при травмі й пораненнях поступово впроваджується в цивільну медицину [92][93][94]. Останніми роками з'являється дедалі більше публікацій, в яких трансфузію одногрупової цільної крові порівнюють з трансфузією її компонентів у найефективнішому співвідношенні 1:1:1 [95].…”

Section: п е р е л и в а н н я к р о в і б е з п р о б и н а індивіду...unclassified

Vascular injury during lumbar discectomy: risk factors, diagnosis, methods of surgical correction, features of anaesthetic management and intensive care

Nekhlopochyn,

Pylypenko,

Dubrov

2023

Ukr Neurosurg J

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One of the priority tasks in neurosurgery is to reduce the frequency of postoperative complications and mortality. Lumbar discectomy is the most frequently performed intervention in spinal neurosurgery and it is a fairly safe procedure. One of the possible intraoperative surgical complications, that threatens the patient’s life is vascular injury. The first clinical case of damage to the large vessels during discectomy was described in 1945. It is believed that the frequency of this complication is 1‒5 cases per 10,000 surgical interventions, but the literature notes that these figures may be significantly underestimated. Some authors indicate that the frequency of this complication, despite the development of surgical techniques over the past 50 years, has not significantly decreased, so it is important for surgeons to be informed and alert about the possibility of such a problem. Among the factors that significantly increase the risk of vascular damage congenital, acquired and technical are determined. Variability of clinical symptoms of damage to lagre vessels is due to different localization of injury, type (arterial, venous or combined) and scale of vascular disaster. For each level of surgical intervention, the "most typical" vessel damage is identified. Vascular injury during discectomy can occur according to three clinical and pathomorphological scenarios: manifestation of vessel rupture symptoms, arteriovenous fistula or a pseudoaneurysm formation. According to different authors, the frequency of these findings varies significantly. This review examines the symptoms of possible variants of vascular damage development during discectomy and describes the characteristics of surgical correction methods. Along with clarifying the location and variant of vascular damage, the critical thing is assessing the amount of blood loss and the rate of ongoing bleeding. In the case of suspected massive bleeding, the paramount importance is the involvement of additional medical personnel for the surgical haemostasis and providing sufficient blood for haemotransfusions. In case of a vascular accident, the key requirement for adequate anaesthetic management is the maintenance of permissive arterial hypotension until the moment of surgical haemostasis. Targeted treatment of haemorrhagic shock in case of damage to large vessels consists of rapid haemostatic resuscitation including blood components and products in a balanced 1:1:1 ratio, such as plasma, red blood cells, fresh frozen plasma, platelets, and coagulation factors. In Ukraine, obtaining a sufficient amount of blood components and products (according to the protocol of massive haemotransfusion) in case of unpredicted blood loss is a difficult task, therefore, in the absence of certain components or blood products, whole blood can be used as an alternative. The number and severity of complications and outcomes primarily depend on the efficiency and timeliness of blood transfusions, along with the speed of surgical arrest of bleeding. This publication describes in detail the main points of management of patients with massive bleeding according to modern international standards and Ukraine regulatory documents.

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Section: п е р е л и в а н н я к р о в і б е з п р о б и н а індивіду...unclassified

Vascular injury during lumbar discectomy: risk factors, diagnosis, methods of surgical correction, features of anaesthetic management and intensive care

Nekhlopochyn,

Pylypenko,

Dubrov

2023

Ukr Neurosurg J

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“…[32] Whole blood is a desirable fluid for patients with traumatic hemorrhagic shock. [33][34][35] It has the advantage of providing red blood cells, plasma, and platelets together in a unit, which simplifies and speeds the process of resuscitation, particularly in austere environments. [36] Shea et al [37] have reported that the use of low-titer group O whole blood is independently associated with improved survival compared to component therapy in adults with severe traumatic hemorrhage.…”

Section: Research Hotspots and Emerging Topicsmentioning

confidence: 99%

A bibliometric analysis of publications on trauma-related hemorrhagic shock from 2012 to 2022: Research landscape and future trends

Du¹,

Wang²

2023

Medicine

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Trauma-related hemorrhagic shock is a global problem. This study aimed to analyze the knowledge domain and frontiers of traumarelated hemorrhagic shock research through a bibliometric analysis. Articles on trauma-related hemorrhagic shock published between 2012 and 2022 were retrieved from the Web of Science Core Collection, and a bibliometric analysis was conducted using CiteSpace and VOSviewer. A total of 3116 articles and reviews were analyzed. These publications primarily came from 441 institutions in 80 countries, with the USA having the highest number of publications, followed by China. Among the publications, Ernest E. Moore published the most papers, whereas John B. Holcomb had the most co-citations. The most productive institution was the University of Pittsburgh in the USA. The keyword burst and reference clustering analysis indicated that "reboa," "whole blood," "exsome," "glycocalyx," "endotheliopathy," and "predictor" are new trends and developing areas of interest. With the help of CiteSpace and VOSviewer, this study provides a deeper understanding of the research landscape, frontier hotspots, and future trends in trauma-related hemorrhagic shock over the last decade. "Whole blood" instead of "component therapy" shows potential advantage while "REBOA" is increasingly discussed in rapid hemostasis. This study provides important clues for researchers to understand the knowledge domain and frontiers of this study field.

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“…The benefits of transfusing LTOWB include more effective platelet therapy, reduced preservative transfusion preventing the dilution of the products, higher concentration of specific clotting factors, as well as the recommended 1:1:1 ratio of red blood cells, plasma, and platelets for trauma resuscitation within a single product [6]. Further, these benefits are delivered in a single product and transfusion versus multiple products and transfusions, which decreases the patient's exposure to multiple blood donors and the risk of blood borne disease transmission [6].…”

Section: Introductionmentioning

confidence: 99%

Variations in low titer group O whole blood practices in the United States

Z Lund,

Kohli,

Nicholaou

et al. 2023

Int J Blood Transfus Immunohematol

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Aims: Blood banking is a strictly monitored industry in the United States (US) with regulatory bodies and accrediting agencies establishing and enforcing standards for the collection, testing, and transfusion of blood products. However, there is a lack of standardization for the increasingly popular blood product low titer group O whole blood (LTOWB). The aims of our survey were to assess the degree of variation in the processes and procedures involved in the collection, manufacture, testing, storage, and transfusion of LTOWB products, which could serve as a resource for establishing future standards. Methods: A survey was written using Qualtrics software. The link to the online survey was sent via email to individuals practicing within blood collection and transfusing facilities in the US. The email addresses were obtained using contact databases from two professional immunohematology and transfusion medicine organizations and one specialist in blood banking (SBB) academic program. Results: A total of 64 responses demonstrates vastly varying practices between facilities among the donor acceptance criteria, antibody titer testing methodology, frequency of donor testing, antibody isotype tested, acceptable titer level, blood component manufacturing process, unit limit per patient, and where and when the units are transfused. Conclusion: The collection and transfusion of LTOWB products continues to increase in the US, but there is notable variability in the manufacture, testing, storage, and transfusion of LTOWB products due to the few defined standards regarding LTOWB including an established acceptable titer threshold. The degree of variation among facilities that collect, test, and transfuse LTOWB is clearly apparent throughout the US.

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The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma

Cited by 8 publications

References 33 publications

Vascular injury during lumbar discectomy: risk factors, diagnosis, methods of surgical correction, features of anaesthetic management and intensive care

Vascular injury during lumbar discectomy: risk factors, diagnosis, methods of surgical correction, features of anaesthetic management and intensive care

A bibliometric analysis of publications on trauma-related hemorrhagic shock from 2012 to 2022: Research landscape and future trends

Variations in low titer group O whole blood practices in the United States

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