Whole blood transfusion: which role in traumatic hemorrhagic shock resuscitation?

Authors

  • Pierre-Yves Cordier Service de réanimation, Hôpital d’Instruction des Armées Laveran, 34 boulevard Laveran, 13384 Marseille, France
  • Frédérik Bélot-De Saint Léger Service de réanimation, Hôpital d’Instruction des Armées Laveran, 34 boulevard Laveran, 13384 Marseille, France
  • Pierre Pasquier 1. Service de réanimation, Hôpital d’Instruction des Armées, Percy, 101 avenue Henri Barbusse, 92141 Clamart, France. 2. École du Val-de-Grâce, 1 place Alphonse Laveran, 75005 Paris, France.
  • Christophe Martinaud 1. École du Val-de-Grâce, 1 place Alphonse Laveran, 75005 Paris, France. 2. Centre de transfusion sanguine des Armées (CTSA), 1 rue Raoul Batany, 92140 Clamart, France.

DOI:

https://doi.org/10.37051/mir-00035

Keywords:

transfusion, whole blood, massive hemorrhage, trauma, damage control

Abstract

Blood transfusion has developed and progressed in step with military conflicts. Blood groups and cross-matching rules discovery led to identifying "universal donors". Whole blood fractionation and the differentiated storage of its components improved transfusion safety and conservation of the different blood products. 

While the majority of preventable trauma deaths are related to massive bleeding, recent military engagements highlighted the importance of early transfusion and targeted resuscitation against coagulopathy. In the acute phase, red blood cells, coagulation factors and platelets are administered according to a transfusion ratio strategy. However, this strategy faces logistical difficulties related to the different storage conditions of blood products, their availability delay, and the workload that their transfusion imposes in emergency context.

In austere environments, fresh whole blood collection and transfusion have remained an alternative technique that has shown clinical and logistical value. Civilian and military teams subsequently demonstrated the feasibility of low hemolysin titer group O whole blood 4°C storage then transfusion, in order to obtain a universal transfusion product available without delay. 

Published

2020-10-12

How to Cite

Cordier, P.-Y., Bélot-De Saint Léger, F., Pasquier, P., & Martinaud, C. (2020). Whole blood transfusion: which role in traumatic hemorrhagic shock resuscitation?. Médecine Intensive Réanimation. https://doi.org/10.37051/mir-00035

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