Fresh Whole Blood Transfusion for a Combat Casualty in Austere Combat Environment

Cordova, Christopher B.; Andrew, P; Spinella, Philip C.

doi:10.55460/6wr8-ner8

Cited by 23 publications

(12 citation statements)

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“…The use of fresh whole blood, which was associated with improved survival rates in Iraq, 18 and has been adopted by many national SOF DCR and DCS teams. These fresh whole blood programs use prescreened and tested donors, to minimize the risk of transfusion‐transmitted infections 19 . Fully tested and screened cold whole blood is also used by US SOF, which reduces the need to bring packed red blood cells, plasma, and platelets separately 20 …”

Section: Resultsmentioning

confidence: 99%

“…These fresh whole blood programs use prescreened and tested donors, to minimize the risk of transfusiontransmitted infections. 19 Fully tested and screened cold whole blood is also used by US SOF, which reduces the need to bring packed red blood cells, plasma, and platelets separately. 20 Lyophilized blood products such as freeze-dried plasma and fibrinogen concentrate are increasingly being adopted by SOF DCR and DCS teams as refrigeration is not required for storage of the product.…”

Section: Blood Productsmentioning

confidence: 99%

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Effect of special operational forces surgical resuscitation teams on combat casualty survival: A narrative review

et al. 2022

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Importance The most common cause of preventable death on the conventional battlefield or on special operations force (SOF) missions is hemorrhage. SOF missions may take place in remote and austere locations. Many preventable deaths in combat occur within 30 min of wounding. Therefore, SOF damage control resuscitation (DCR) and damage control surgery (DCS) teams may improve combat casualty survival in the SOF environment. Objective To determine the effect of SOF DCR and DCS teams on combat casualty survival. Also, to describe commonalities in team structure, logistics, and blood product usage. Design A narrative review of the English literature used a Medline and Embase search strategy. The authors were contacted for more details as required. The risk of bias was assessed using the Cochrane Collaboration's ROBINS‐I tool. Pooling of data was not done to the heterogeneity of studies. Results Weak evidence was identified showing a clinical benefit of SOF DCR and DCS teams. Conflicting evidence from less rigorous studies was also found. The overall risk of bias using ROBINS‐I was serious to critical. Several commonalities in team structure, training, and logistics were found. Conclusions and Relevance There is conflicting evidence regarding the effect SOF DCR and DCS teams have on combat casualty survival. There is no strong evidence that SOF DCR and DCS teams cause harm. More robust data collection is recommended to evaluate these teams.

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Section: Resultsmentioning

confidence: 99%

Section: Blood Productsmentioning

confidence: 99%

Effect of special operational forces surgical resuscitation teams on combat casualty survival: A narrative review

et al. 2022

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“…However, military use of WB continued due to blood needs in far forward environments, and today the use of WB is increasing as a haemostatic resuscitation strategy. The recent conflicts in Iraq, Afghanistan, and other areas in the Middle East have seen over 10 000 WB units safely transfused . With the increased focus on rapid delivery of blood components in a ratio‐based fashion approaching 1:1:1 in military settings in conjunction with expanded use of WB transfusion, as well as the recognition that balanced haemostatic resuscitation as part of damage control resuscitation in haemorrhagic shock patients can simultaneously address both haemodynamic and coagulation defects, balanced haemostatic resuscitation is integral to optimizing care of the haemorrhaging soldier .…”

Section: Brief History and Current Use Of Whole Bloodmentioning

confidence: 99%

Review of whole blood use in trauma

Madden

Raval

2019

ISBT Science Series

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Traumatic haemorrhage is the leading cause of preventable death in both military and civilian settings. Haemostatic resuscitation with red cells, plasma, and platelets helps to address the problems caused by haemorrhagic shock and coagulopathy associated with trauma to improve survival. Whole blood (WB) is once again the primary recommended resuscitative blood product to be transfused in the military setting, and successes here have led to renewed interest in WB use in civilian trauma. This review provides a brief history of WB in trauma, highlights recent WB use, and discusses current considerations with transfusing WB.

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“…[1][2][3][4][5][6][7][8][9] In the military setting, field transfusion of fresh and cold-stored whole blood (low titer type O Rh-D+ whole blood [LTO + WB]) transfusion has been successfully implemented and has been shown to influence outcomes on the battlefield. [10][11][12][13][14][15][16] Meanwhile, the use of LTO + WB in the civilian setting has increased with both in-hospital transfusion and prehospital transfusion gaining popularity. 17 While several studies have described the efficacy of prehospital transfusions for nontrauma patients in hemorrhagic shock, [18][19][20][21] the pitfalls of transfusion in this population and of dedicated transfusion protocols pose unique challenges.…”

Section: Introductionmentioning

confidence: 99%

“…Recent evidence has suggested that transfusion of prehospital blood products results in improved outcomes for trauma patients 1‐9 . In the military setting, field transfusion of fresh and cold‐stored whole blood (low titer type O Rh‐D+ whole blood [LTO + WB]) transfusion has been successfully implemented and has been shown to influence outcomes on the battlefield 10‐16 . Meanwhile, the use of LTO + WB in the civilian setting has increased with both in‐hospital transfusion and prehospital transfusion gaining popularity 17 .…”

Section: Introductionmentioning

confidence: 99%

The regional whole blood program in San Antonio, TX: A 3‐year update on prehospital and in‐hospital transfusion practices for traumatic and non‐traumatic hemorrhage

et al. 2022

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Low titer type O Rh‐D + whole blood (LTO + WB) has become a first‐line resuscitation medium for hemorrhagic shock in many centers around the World. Showing early effectiveness on the battlefield, LTO + WB is used in both the pre‐hospital and in‐hospital settings for traumatic and non‐traumatic hemorrhage resuscitation. Starting in 2018, the San Antonio Whole Blood Collaborative has worked to provide LTO + WB across Southwest Texas, initially in the form of remote damage control resuscitation followed by in‐hospital trauma resuscitation. This program has since expanded to include pediatric trauma resuscitation, obstetric hemorrhage, females of childbearing potential, and non‐traumatic hemorrhage. The objective of this manuscript is to provide a three‐year update on the successes and expansion of this system and outline resuscitation challenges in special populations.

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Fresh Whole Blood Transfusion for a Combat Casualty in Austere Combat Environment

Cited by 23 publications

References 0 publications

Effect of special operational forces surgical resuscitation teams on combat casualty survival: A narrative review

Effect of special operational forces surgical resuscitation teams on combat casualty survival: A narrative review

Review of whole blood use in trauma

The regional whole blood program in San Antonio, TX: A 3‐year update on prehospital and in‐hospital transfusion practices for traumatic and non‐traumatic hemorrhage

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