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Whole Blood for the Resuscitation of Massively Bleeding Civilian Patients

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Trauma Induced Coagulopathy

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Abstract

The use of whole blood for the resuscitation of trauma patients is not a new concept, but it is currently experiencing a renaissance given the modern appreciation for the need for balanced resuscitation and the survival benefits of the early intervention of blood products. When used in an uncrossmatched manner, the whole blood must be group O and have low titer anti-A and anti-B; this is known as low-titer group O whole blood (LTOWB). The serological safety of using LTOWB in the civilian setting has been demonstrated, although institutions can determine the maximum number of units to administer to a massively hemorrhaging patient. Unresolved questions surrounding the use of LTOWB include for how long the platelets are active during cold storage, whether leukoreduction affects platelet function, and a titer threshold that optimizes patient safety and LTOWB inventory management.

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Acknowledgments

The authors thank Drs. Pierre Tiberghien and Sylvain Ausset for providing information on the STORHM trial.

Disclosures

M.H.Y. One-off interventions: paid academic lectures (with reimbursed travel expenses) for Terumo, the manufacturer of a platelet-sparing whole blood leukoreduction blood collection kit. The other authors declare that they have no competing interest.

No funding was obtained to write this chapter.

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Authors and Affiliations

  1. University of Pittsburgh, Pittsburgh, PA, USA

    Mark H. Yazer

  2. Tel Aviv University, Tel Aviv-Yafo, Israel

    Mark H. Yazer

  3. University of Southern Denmark, Odense, Denmark

    Mark H. Yazer

  4. University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, PA, USA

    Jansen N. Seheult

  5. Allegheny Health Network, Department of Internal Medicine, Pittsburgh, PA, USA

    Marshall P. Bahr

  6. St. Michael’s Hospital/Canadian Armed Forces, Department of Surgery, Toronto, ON, Canada

    Andrew N. Beckett

  7. Division of Transfusion Medicine, University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, PA, USA

    Darrell J. Triulzi

  8. Washington University School of Medicine St. Louis, Pediatric Critical Care, St. Louis, MO, USA

    Philip C. Spinella

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Corresponding author

Correspondence to Mark H. Yazer .

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Editors and Affiliations

  1. Department of Surgery, University of Colorado, Aurora, CO, USA

    Hunter B. Moore

  2. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Matthew D. Neal

  3. Department of Surgery, University of Colorado Denver, Ernest E Moore Shock TraumaCenter at Denver Health, Denver, CO, USA

    Ernest E. Moore

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Yazer, M.H., Seheult, J.N., Bahr, M.P., Beckett, A.N., Triulzi, D.J., Spinella, P.C. (2021). Whole Blood for the Resuscitation of Massively Bleeding Civilian Patients. In: Moore, H.B., Neal, M.D., Moore, E.E. (eds) Trauma Induced Coagulopathy. Springer, Cham. https://doi.org/10.1007/978-3-030-53606-0_24

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