Whole Blood in Trauma

In this ResusX podcast episode, Dr. Salina Wydo discusses the history and rationale behind using whole blood transfusions for trauma patients with massive hemorrhage, reviewing existing evidence on its safety and effectiveness compared to component blood products. She explains how whole blood fell out of favor after Vietnam but has seen resurgence based on military experience, and describes the practical aspects of implementing a whole blood program at a civilian trauma center, sharing early results that demonstrate it is a feasible option.

Here are 5 key takeaways:

1. Whole blood provides benefits over components like higher oxygen carrying capacity, less breakdown, and more efficient hemostatic factors.
2. Evidence shows low-titer type O whole blood carries minimal risk of transfusion reactions or allo-immunization compared to potential benefits.
3. Early civilian trauma center experiences demonstrate feasibility of implementing whole blood programs, with protocols expanding eligible recipients.
4. Current research is limited by low-quality evidence and bias, but shows no inferiority of whole blood to component therapy for massive transfusion.
5. More robust multi-center trials are underway which will provide higher-quality data on the role of whole blood in hemorrhagic shock resuscitation.

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