Transfusion of Stored Fresh Whole Blood in a Civilian Trauma Center: A Prospective Evaluation of Feasibility and Outcomes
Henry Cryer, MD
Resuscitation protocols for trauma patients presenting with significant bleeding utilize administration of components of blood including RBCs, plasma, and platelets. Despite improvements in emergency surgery and critical care, trauma patients with severe bleeding still suffer from high incidence of complications and death compared to patients that require fewer or no transfusions.
Recent studies from military centers indicate that transfusion of fresh whole blood (FWB) may be more beneficial than individual blood components in patients with severe hemorrhage. This has not been studied in civilian trauma patients mainly due to the technical difficulties and costs.
This is a feasibility and hospital outcomes study using FWB (storage time of five days) for resuscitating trauma patients with significant bleeding. A cohort of adult trauma patients presenting with severe hemorrhage and receiving resuscitation with FWB will be prospectively compared to a control group of patients receiving standard component therapy. The shelf-life of whole blood, cost of treatment, levels of clotting and inflammatory markers in patient’s blood samples, as well as the incidence of persistent bleeding, development of blood clots, infections, and mortality will be compared between the two groups.
This study is designed to determine whether FWB transfusions are feasible in a civilian trauma center and to determine whether resuscitation using FWB is superior to component therapy in patients with severe hemorrhage.