Preferential whole blood transfusion during the early resuscitation period is associated with decreased mortality and transfusion requirements in traumatically injured patients

IntroductionWhole blood (WB) transfusion represents a promising resuscitation strategy for trauma patients. However, a paucity of data surrounding the optimal incorporation of WB into resuscitation strategies persists. We hypothesized that traumatically injured patients who received a greater propor...

Full description

Saved in:
Bibliographic Details
Published in:Trauma surgery & acute care open 2024-04, Vol.9 (1), p.e001358-e001358
Main Authors: Lammers, Daniel, Hu, Parker, Rokayak, Omar, Baird, Emily W, Betzold, Richard D, Hashmi, Zain, Kerby, Jeffrey David, Jansen, Jan O, Holcomb, John B
Format: Article
Language:English
Subjects:
Blood pressure
Blood products
Blood transfusions
Glasgow Coma Scale
Heart rate
Hemorrhagic shock
Mortality
Observational studies
Ostomy
Patients
resuscitation
Trauma
Trauma centers
Traumatic brain injury
Whole blood
World Trauma Congress article
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:IntroductionWhole blood (WB) transfusion represents a promising resuscitation strategy for trauma patients. However, a paucity of data surrounding the optimal incorporation of WB into resuscitation strategies persists. We hypothesized that traumatically injured patients who received a greater proportion of WB compared with blood product components during their resuscitative efforts would have improved early mortality outcomes and decreased transfusion requirements compared with those who received a greater proportion of blood product components.MethodsRetrospective review from our Level 1 trauma center of trauma patients during their initial resuscitation (2019–2022) was performed. WB to packed red blood cell ratios (WB:RBC) were assigned to patients based on their respective blood product resuscitation at 1, 2, 3, and 24 hours from presentation. Multivariable regression models were constructed to assess the relationship of WB:RBC to 4 and 24-hour mortality, and 24-hour transfusion requirements.Results390 patients were evaluated (79% male, median age of 33 years old, 48% penetrating injury rate, and a median Injury Severity Score of 27). Overall mortality at 4 hours was 9%, while 24-hour mortality was 12%. A significantly decreased 4-hour mortality was demonstrated in patients who displayed a WB:RBC≥1 at 1 hour (5.9% vs. 12.3%; OR 0.17, p=0.015), 2 hours (5.5% vs. 13%; OR 0.16, p=0.019), and 3 hours (5.5% vs. 13%, OR 0.18, p
ISSN:2397-5776
2397-5776
DOI:10.1136/tsaco-2023-001358