Minimal tactical impact and maximal donor safety after a buddy transfusion: A study on elite soldier performances in both laboratory and field environments

Abstract

Background The major causes of death of combat casualties in austere environments are related to hemorrhage and occur early after injury. The implementation of a walking blood bank may overcome the logistical issues raised using blood component therapy. Nonetheless, it is important to ensure that this buddy transfusion is not going to compromise the mission success by altering the donor's performance. The results available so far cannot rule out this issue with certainty. Therefore, this study aimed at investigating the immediate effect of a 450‐ml blood donation on the performances of elite soldiers in laboratory and field environments. Study design and methods This double‐blind, randomized controlled study included two experiments. For both experiments, subjects were randomly assigned either to a control group (n1 = n2 = 7) or to a 450‐ml‐blood‐bag donation group (n1 = 7 and n2 = 8). All participants underwent before and after a potential blood donation a multifactorial assessment including adapted physical tasks, hematological variables, vigilance parameters, and subjective assessments. Results No significant results were evidenced in this study. There was no impact of blood donation on the participants' performances in both the hospital and the combat‐like environments. Conclusion From a donor's point of view, a 450‐ml blood donation has no impact on the required abilities of our elite soldiers to fulfill a demanding tactical mission. Thus, the results of this study support the fact that buddy transfusions could be part of the operational clinical armamentarium in austere environments for elite soldiers when no blood components are available.

When do benefits turn to risks? Impact of a 900 mL whole blood donation on Special Forces performance

“…In terms of vigilance, no effect of a 900 mL blood donation could be demonstrated, either immediately or in the long term. These results are in line with our previous findings after a standard double‐blind blood donation 9 . Overall, reaction times improved over time.…”

“…We would like to emphasize that these results can certainly not be generalized to other members of the military or to the average civilian population. The population studied has already demonstrated tolerance to donating 450 mL of blood and was able to perform combat tasks in the same way 8,9 . In addition, this population has been shown to possess a higher circulating volume, comparable to highly trained athletes.…”

“…These results are in line with our previous findings after a standard double-blind blood donation. 9 Overall, reaction times improved over time. There was also no significant effect on complex responses involving executive functions.…”

“…Previous studies showed no significant effect of a 450 mL blood transfusion either on the vigilance of the operators or on the physical performances 8,9 . This means that a blood donation of 450 mL has no impact on the ability of the donor to carry out the mission and should not have any tactical consequences 8,10 .…”

Prehospital care according to the principles of Damage Control Resuscitation in the conditions of modern warfare (literature review)

“…Для его формирования у всего личного состава, участвующего в бое вых операциях, предварительно определяют группу крови и титр анти A/анти Bантител при 0 (I) группе крови, проводят обследова ние на наличие гемоконтактных инфекций [40]. Исследования на добровольцах показали, что сдача 450 мл крови не вызывает значительных изменений когнитивных и физических показа телей и не снижает способности донора выпол нять боевые задачи [12].…”