Journal article
Cold-stored whole blood: A better method of trauma resuscitation?
The journal of trauma and acute care surgery, Vol.87(5), pp.1035-1040
01 Nov 2019
PMID: 31389912
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND Cold-stored whole blood (CWB) provides a balance of red blood cells, plasma, and platelets in less anticoagulant volume than standard blood component therapy (BCT). We hypothesize that patients receiving CWB along with BCT have improved survival compared with patients receiving only BCT. METHODS We performed a dual-center case-match study of trauma patients who received CWB and BCT at two urban, Level-I Trauma Centers. Criteria to receive CWB included boys 16 years of older, women older than 50 years, SBP less than 90 mm Hg, and identifiable source of hemorrhage. We performed a 2:1 propensity match against any trauma patient who received 1 unit or greater of packed red cells during their initial trauma bay resuscitation. Endpoints included trauma bay mortality, 30-day mortality, laboratory values at 4 hours and 24 hours, and overall blood product utilization. Comparisons were made with Wilcoxon-ranked sum and Fisher's exact test, p less than 0.05 was significant. RESULTS Between both institutions, a total of 107 patients received CWB during the study period with 91 being matched to 182 BCT patients for analysis. Hemodynamic parameters of the patients in both groups at the time of presentation were similar. The CWB patients had higher mean hemoglobin (10 +/- 2 g/dL vs. 11 +/- 2 g/dL; p < 0.001) and hematocrit (29.2 +/- 6.1% vs. 32.1 +/- 5.8%; p < 0.001) at 24 hours. Importantly, trauma bay mortality was less in CWB patients (8.8% vs. 2.2%;p = 0.039). Thirty-day mortality was not different in CWB patients, and there were no differences in the total amount of blood products transfused at the 4-hour and 24-hour periods. CONCLUSION Cold-stored whole blood offers the benefit of a balanced resuscitation with improved trauma bay survival and higher mean hemoglobin at 24 hours. A larger, prospective study is needed to determine whether it has a longer-term survival benefit for severely injured patients.
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Details
- Title
- Cold-stored whole blood: A better method of trauma resuscitation?
- Creators
- Joshua Paul Hazelton - HersheyJeremy W. Cannon - HersheyCatherine Zatorski - HersheyJanika San Roman - Cooper Univ Hosp, Div Trauma Surg Crit Care & Acute Care Surg, Camden, NJ USASarah A. Moore - HersheyAndrew J. Young - HersheyMadhu Subramanian - HersheyJessica F. Guzman - HersheyFranz Fogt - HersheyAnna Moran - HersheyJohn Gaughan - HersheyMark J. Seamon - HersheyJohn Porter - Hershey
- Publication Details
- The journal of trauma and acute care surgery, Vol.87(5), pp.1035-1040
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000504900200007
- Scopus ID
- 2-s2.0-85074184914
- Other Identifier
- 991022056904604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Surgery