Whole Blood for Resuscitation of Traumatic Hemorrhagic Shock in Adults.
Allison R Jones, Justin L Miller, Jan O Jansen and 1 others
PMID 34699424WHAT IT FOUND
Review evidence does not show whole blood lowers mortality compared with separate blood components in adult traumatic hemorrhagic shock.
It may simplify transfusion logistics and reduce later blood product use, but randomized trials are needed.
Key findings
01The reviewed trauma studies did not show improved mortality with whole blood compared with component therapy.
02In a civilian trauma center study, low-titer whole blood was associated with more than a 50% reduction in post-emergency department blood product use, but mortality did not differ.
03A leukoreduction study found no difference in 24-hour survival among 167 patients receiving leukocyte-reduced or non-leukocyte-reduced low-titer whole blood.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review without a reported search strategy or appraisal method, so it is not a systematic review. Most cited studies were observational, and whole blood definitions varied widely, so the evidence cannot prove whole blood is better than component therapy. The randomized trial cited was designed for feasibility and was not powered to detect mortality differences. Many benefits, including easier administration and reduced nursing workload, are theoretical rather than measured outcomes.
Declared interests
The authors report no related conflicts of interest.
The easy way to misread this
Do not conclude that whole blood improves survival in adult trauma hemorrhage. The reviewed studies did not show a mortality improvement, and the evidence is mostly observational with varying whole blood definitions.