Journal Review in Trauma Surgery: Whole Blood Resuscitation in Trauma

Do you find yourself saying: “Hey, what’s the big idea with that newfangled whole blood in the refrigerator next to the trauma bay?” Like using whole blood but not sure why? Don’t like using whole blood but not sure why? Join us for a 30 minute power session in whole blood where we try to get you the information you need to know!

Hosts:
- Michael Cobler-Lichter, MD, PGY4/R2:
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@mdcobler (X/twitter)

- Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow
University of Pennsylvania
Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency
@urrechisme (X/twitter)

- Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending:
Loma Linda University
Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship

- Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 6 years in practice
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@jpmeizoso (twitter)

Learning Objectives:
- Describe the proposed benefits of whole blood resuscitation in trauma

- Identify current problems with synthesizing the existing literature on whole blood resuscitation in trauma

- Propose needed areas for future research regarding whole blood resuscitation in trauma

Quick Hits:
1. There is significant heterogeneity in study design across whole blood resuscitation studies, complicating comparison

2. There is likely a mortality benefit to whole blood resuscitation in trauma, however this is likely dependent on the specific population

3. Future research directions should focus on prospective randomized work to try and better quantify the exact benefit of whole blood, and determine in which populations this benefit is actually realized

References

1. Hazelton JP, Ssentongo AE, Oh JS, Ssentongo P, Seamon MJ, Byrne JP, Armento IG, Jenkins DH, Braverman MA, Mentzer C, Leonard GC, Perea LL, Docherty CK, Dunn JA, Smoot B, Martin MJ, Badiee J, Luis AJ, Murray JL, Noorbakhsh MR, Babowice JE, Mains C, Madayag RM, Kaafarani HMA, Mokhtari AK, Moore SA, Madden K, Tanner A 2nd, Redmond D, Millia DJ, Brandolino A, Nguyen U, Chinchilli V, Armen SB, Porter JM. Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding: A Multicenter Study. Ann Surg. 2022 Oct 1;276(4):579-588. doi: 10.1097/SLA.0000000000005603. Epub 2022 Jul 18. PMID: 35848743.
https://pubmed.ncbi.nlm.nih.gov/35848743/

2. Sperry JL, Cotton BA, Luther JF, Cannon JW, Schreiber MA, Moore EE, Namias N, Minei JP, Wisniewski SR, Guyette FX; Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group. Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality. J Am Coll Surg. 2023 Aug 1;237(2):206-219. doi: 10.1097/XCS.0000000000000708. Epub 2023 Apr 11. PMID: 37039365; PMCID: PMC10344433.
https://pubmed.ncbi.nlm.nih.gov/37039365/

3. Meizoso JP, Cotton BA, Lawless RA, et al. Whole blood resuscitation for injured patients requiring transfusion: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2024;97(3):460-470. doi:10.1097/TA.0000000000004327
https://pubmed.ncbi.nlm.nih.gov/38531812/

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