Fresh Warm Whole Blood Use During Combat.

Does a balanced transfusion ratio of plasma to packed red blood cells improve outcomes in both trauma and surgical patients? A meta-analysis of randomized controlled trials and observational studies

“…During the wars in Iraq and Afghanistan, the U.S. military utilize whole blood in austere situations for massive blood transfusion due to a rapidly available pool of donors. Initial studies on this transfusion method suggested that whole blood was as good as, and perhaps even superior to, traditional component transfusion practices with regards to coagulopathy in the setting of massive hemorrhage [5][6][7] . Other studies from civilian trauma suggested an advantage with early transfusion of FFP and platelets [8][9][10] .…”

Fresh Whole Blood Transfusion: A Controversial Military Practice

“…1,4,8,[22][23][24][25] In a retrospective study of the results of the FWB procedures for one forward-deployed US military hospital in 2004, 87 patients received 545 units. 26 Fresh whole blood was called for after a patient was identified as requiring a massive transfusion. Transfusion of FWB resulted in significant improvements in both hemoglobin concentration (from 9.0 Ϯ 2.6 to 10.7 Ϯ 1.9 g/dL) and coagulation parameters (international normalized ratio from 2.0 Ϯ 1.1 to 1.6 Ϯ 0.9).…”