Warm storage of whole blood for 72 hours

Hughes, James L.; Macdonald, Victor W.; Hess, John R.

doi:10.1111/j.1537-2995.2007.01429.x

Cited by 63 publications

(55 citation statements)

References 33 publications

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“…16 Trauma transfusion guidelines were extrapolated from the elective surgery setting, and recent publications suggest that this practice might not be best practice given the acidosis and hypercoagulability associated with hemorrhagic shock. 15,17 Recent reports now indicate that use of a 1:1:1 ratio (ie, equal units of FFP, RBCs, and platelets) of component therapy, mirroring the naturally occurring physiological ratios in whole blood, leads to improved outcomes. 6,18,19 Achieving the rapid administration of a 1:1:1 ratio is challenging for even the most experienced staff in trauma centers and all the more arduous in a mass casualty or disaster situation.…”

Section: Blood Component Therapymentioning

confidence: 99%

Fresh Whole Blood Transfusion: Military and Civilian Implications

Goforth

Tranberg

Boyer³

et al. 2016

Critical Care Nurse

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Uncontrolled hemorrhage and exsanguination are the leading cause of preventable death, and resuscitative therapy is a critical component for survival. In various combinations, fresh whole blood, blood components, colloids, and crystalloids have all been staples of trauma care. The use of fresh whole blood is a well-established military practice that has saved the lives of thousands of American and coalition military personnel. Civilian use of fresh whole blood is far less established owing to the wide availability of individual blood components. However, this highly tailored blood supply is vulnerable to both natural and man-made disasters. In the event of such disruption, such as a major hurricane, it may be necessary for civilian hospitals to rapidly enact a fresh whole blood program. Therefore, the aim of this article is to review the current use of blood therapy for trauma resuscitation, the US military's approach to fresh whole blood, and how maintaining a civilian capacity for fresh whole blood collection in the event of future man-made and natural disasters is key to promoting survival from trauma. (Critical Care Nurse. 2016; 36[3] 1 Hemorrhage, in turn, quickly leads to hypoperfusion, or "shock," and coagulopathy.2 Death due to hemorrhage occurs soon after trauma, usually within the first 6 hours of hospital admission.3,4 US hospital data on trauma patients indicates that coagulopathy, which is associated with early mortality, occurs in 28% of hospital admissions.5 Determining which patients are at risk of shock and coagulopathy developing and applying resuscitation strategies to prevent these processes directly improve survival. 6 In various combinations, fresh whole blood (FWB), blood component therapy (BCT), colloids, and crystalloids have all been staples of trauma care. Therefore, our aim is to review the current use of blood therapy for trauma resuscitation and the US military's approach to FWB. This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Compare and contrast the evidence regarding the transfusion of fresh whole blood 2. Describe the application of fresh whole blood transfusion in the event of a man-made or natural disaster 3. Describe the steps and supplies necessary for the safe collection of fresh whole blood To complete evaluation for CE contact hour(s) for test #C163, visit www.ccnonline.org and click the "CE Articles" button. No CE test fee for AACN members.

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Section: Blood Component Therapymentioning

confidence: 99%

Fresh Whole Blood Transfusion: Military and Civilian Implications

Goforth

Tranberg

Boyer³

et al. 2016

Critical Care Nurse

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“…Thus, consistent results were not obtained from the samples stored at 258C for 6 h. Therefore, it is certain that the use of blood stored at RT for some time may be undesirable in the examination of platelet function or blood coagulability, though further examination is required to identify the effects of benchtop storage on platelet activities, as recently reported that platelet function and plasma coagulation factor activity during storage of whole blood at RT up to 72 h were surprisingly modest as compared with literature values [38]. Our present study demonstrated that platelet responsiveness is enhanced during cold storage of whole blood for 6 h.…”

Section: Discussionmentioning

confidence: 87%

Enhanced platelet responsiveness due to chilling and its relation to CD40 ligand level and platelet–leukocyte aggregate formation

Ayukawa

Nakamura

Kariyazono

et al. 2009

Blood Coagulation &Amp; Fibrinolysis

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To investigate platelet responsiveness during cold storage of whole blood, we examined platelet aggregation, expression of CD40 ligand (CD40L) on platelets, the plasma levels of soluble form of CD40L (sCD40L) as well as platelet-leukocyte aggregates. Flow cytometry analysis was performed to investigate platelet-leukocyte aggregate formation using antibodies against CD42b and CD45 and platelet activation using antibodies against P-selectin and PAC-1. Blood samples were collected from healthy volunteers, patients with cardiovascular diseases, or both. In the healthy volunteers' blood samples stored at 4 degrees C for 6 h, platelet aggregation in response to 1 micromol/l ADP was enhanced, and released levels of soluble form of P-selectin and thromboxane B2 in response to 1 micromol/l ADP markedly increased. In the samples stored at 4 degrees C for 6 h but not stimulated by any agonists, CD40L expression on the platelets was increased, and plasma levels of sCD40L were also elevated. Under the same condition, the increase in simultaneous expression of CD45 and CD42b was observed. In patients with cardiovascular diseases, the platelet aggregability, coexpression of P-selectin and PAC-1, expression of CD40L on platelets and both CD45-bound and CD42b-bound subsets were all comparable to those of healthy volunteers' samples stored at 4 degrees C for 6 h. Plasma levels of sCD40L in patients were higher than those in healthy volunteers' control. Taken together, storage of whole blood at 4 degrees C for 6 h caused platelet activation comparable to that of patients with cardiovascular diseases, and enhanced platelet activity in such patients may be involved in increased risk for thromboembolic events.

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“…Such a question has only been addressed for whole blood that underwent no further component processing [64]. Apart from a depletion of 2,3-DPG at t = 48 hours when either stored at 19°C or 25°C, small changes in red cell quality with respect to hemolysis, ATP, and free potassium were found.…”

Section: Holding Of Whole Blood Beyond 24 Hoursmentioning

confidence: 93%

“…Thus, a holding time up to 30 hours might be appealing. Both the publication by Hughes et al [64] with a 72-hour storage and by Van der Meer et al [18] with a 24-to 26-hour storage time show that after 24 hours, there is no sudden decline in quality of whole blood or its components, and it should be emphasized that the 24-hour time limit was chosen arbitrarily based on data of the longest storage time that was investigated [6], not by proof that after 24 hours, the units fall off a cliff.…”

Section: Holding Of Whole Blood Beyond 24 Hoursmentioning

confidence: 94%