| 1 | | | | Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries. |
| Journal of Trauma | 04/01/09 | | MilitaryTrauma | | Spinella PC, Perkins JG, Grathwohl KW, Beekley AC, Holcomb JB. Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries. J Trauma. 2009 Apr;66(4 Suppl):S69-76. doi: 10.1097/TA.0b013e31819d85fb. PMID: 19359973; PMCID: PMC3126655. |
| 2 |  | | | Resuscitation and transfusion principles for traumatic hemorrhagic shock. |
| Blood Rev | 11/23/09 | | MilitaryTrauma | | Spinella PC, Holcomb JB. Resuscitation and transfusion principles for traumatic hemorrhagic shock. Blood Rev. 2009 Nov;23(6):231-40. doi: 10.1016/j.blre.2009.07.003. Epub 2009 Aug 19. PMID: 19695750; PMCID: PMC3159517. |
| 3 | | | | Lessons from the tip of the spear: medical advancements from Iraq and Afghanistan |
| | 08/01/12 | | Military | | Schrager JJ, Branson RD, Johannigman JA. Lessons from the tip of the spear: medical advancements from Iraq and Afghanistan. Respir Care. 2012 Aug;57(8):1305-13. doi: 10.4187/respcare.01881. PMID: 22867641. |
| 4 | | | | Symposium on fresh whole blood for severe hemorrhagic shock: from in-hospital to far forward resuscitations |
| | 08/01/12 | | MilitaryTraumaWalking BB | | Spinella PC, Strandenes G, Rein EB, Seghatchian J, Hervig T. Symposium on fresh whole blood for severe hemorrhagic shock: from in-hospital to far forward resuscitations. Transfus Apher Sci. 2012 Feb;46(1):113-7. doi: 10.1016/j.transci.2012.01.002. Epub 2012 Feb 1. PMID: 22300839. |
| 5 | | | | Challenges and possibilities in forward resuscitation |
| | 05/01/14 | | Military | | Hooper TJ, De Pasquale M, Strandenes G, Sunde G, Ward KR. Challenges and possibilities in forward resuscitation. Shock. 2014 May;41 Suppl 1:13-20. doi: 10.1097/SHK.0000000000000096. PMID: 24296432. |
| 6 | | | | Emergency whole-blood use in the field: a simplified protocol for collection and transfusion. |
| | 05/01/14 | | MilitaryWalking BB | | Strandenes G, De Pasquale M, Cap AP, Hervig TA, Kristoffersen EK, Hickey M, Cordova C, Berseus O, Eliassen HS, Fisher L, Williams S, Spinella PC. Emergency whole-blood use in the field: a simplified protocol for collection and transfusion. Shock. 2014 May;41 Suppl 1:76-83. doi: 10.1097/SHK.0000000000000114. PMID: 24365879. |
| 7 | | | | Implementation and execution of civilian remote damage control resuscitation programs |
| Shock | 05/01/14 | | Trauma | | Jenkins D, Stubbs J, Williams S, Berns K, Zielinski M, Strandenes G, Zietlow S. Implementation and execution of civilian remote damage control resuscitation programs. Shock. 2014 May;41 Suppl 1:84-9. doi: 10.1097/SHK.0000000000000133. PMID: 24662783. |
| 8 | | | | Low titer group O whole blood in emergency situations. |
| | 05/01/14 | | Trauma | | Strandenes G, Berséus O, Cap AP, Hervig T, Reade M, Prat N, Sailliol A, Gonzales R, Simon CD, Ness P, Doughty HA, Spinella PC, Kristoffersen EK. Low titer group O whole blood in emergency situations. Shock. 2014 May;41 Suppl 1:70-5. doi: 10.1097/SHK.0000000000000150. PMID: 24569505. |
| 9 | | | | Whole blood: the future of traumatic hemorrhagic shock resuscitation |
| | 05/01/14 | | Trauma | | Murdock AD, Berséus O, Hervig T, Strandenes G, Lunde TH. Whole blood: the future of traumatic hemorrhagic shock resuscitation. Shock. 2014 May;41 Suppl 1:62-9. doi: 10.1097/SHK.0000000000000134. PMID: 24662782. |
| 10 | | | | Fluid Resuscitation for Hemorrhagic Shock in Tactical Combat Casualty Care: TCCC Guidelines Change 14-01--2 June 2014 |
| J spec Oper med | 06/01/14 | TCCC changes whole blood >components > crystalloids | Military | | Butler FK Jr, Holcomb JB, Schreiber MA, Kotwal RS, Jenkins DA, Champion HR, Bowling F, Cap AP, DuBose JJ, Dorlac WC, Dorlac GR, McSwain NE, Timby JW, Blackbourne LH, Stockinger Z, Strandenes G, Weiskopf RB, Gross K, Bailey JA. Fluid Resuscitation for Hemorrhagic Shock in Tactical Combat Casualty Care: TCCC Guidelines Change 14-01--2 June 2014. J Spec Oper Med. 2014 Fall;14(3):13-38. doi: 10.55460/DPOC-JWIY. PMID: 25344706. |
| 11 | | | | Initial safety and feasibility of cold-stored uncrossmatched whole blood transfusion in civilian trauma patients. |
| J Trauma Acute Care Surg | 07/01/16 | Initial feasibility report , 47 patients transfused 2 its each without complication | Rh/ABO incompatibilityTrauma | | Yazer MH, Jackson B, Sperry JL, Alarcon L, Triulzi DJ, Murdock AD. Initial safety and feasibility of cold-stored uncrossmatched whole blood transfusion in civilian trauma patients. J Trauma Acute Care Surg. 2016 Jul;81(1):21-6. doi: 10.1097/TA.0000000000001100. PMID: 27120323. |
| 12 |  | | | Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day Survival. |
| JAMA | 10/01/17 | 6-fold reduction in 24 hour mortality and 3-fold reduction in 30 day mortality IF blood given within the first 34 minutes. Number needed to treat for a survivor was less than or equal to 6 | MilitaryPrehospitalTrauma | https://pmc.ncbi.nlm.nih.gov/articles/PMC5818807/ | Shackelford SA, Del Junco DJ, Powell-Dunford N, Mazuchowski EL, Howard JT, Kotwal RS, Gurney J, Butler FK Jr, Gross K, Stockinger ZT. Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day Survival. JAMA. 2017 Oct 24;318(16):1581-1591 |
| 13 | | | | Use of uncrossmatched cold-stored whole blood in injured children with hemorrhagic shock. |
| JAMA | 02/01/18 | | Pediatric | | Leeper CM, Yazer MH, Cladis FP, Saladino R, Triulzi DJ,Gaines BA. Use of uncrossmatched cold-stored whole blood ininjured children with hemorrhagic shock. JAMA Pediatr. 2018;172:491–2. |
| 14 |  | | | Prehospital low-titer cold-stored whole blood: Philosophy for
ubiquitous utilization of O-positive product for emergency
use in hemorrhage due to injury |
| JTACS | 03/19/18 | Whole blood was safe due to low risk of iso immunization (Soft) | Females/OBTrauma | | McGinity AC, Zhu CS, Greebon L, Xenakis E, Waltman E, Epley E, Cobb D, Jonas R, Nicholson SE, Eastridge BJ, Stewart RM, Jenkins DH. Prehospital low-titer cold-stored whole blood: Philosophy for ubiquitous utilization of O-positive product for emergency use in hemorrhage due to injury. J Trauma Acute Care Surg. 2018 Jun;84(6S Suppl 1):S115-S119. doi: 10.1097/TA.0000000000001905. PMID: 29554040. |
| 15 | | | | Safety profile of uncrossmatched, cold-stored, low-titer, group
O+ whole blood in civilian trauma patients |
| Transfusion | 10/01/18 | Administration of up to 4 units of
LTOWB in civilian trauma resuscitation was not
associated with clinical or biochemical evidence of
hemolysis. Six units per trauma patient are now
permitted at these institutions. | Rh/ABO incompatibilityTrauma | | Seheult JN, Bahr M, Anto V, Alarcon LH, Corcos A, Sperry JL, Triulzi DJ, Yazer MH. Safety profile of uncrossmatched, cold-stored, low-titer, group O+ whole blood in civilian trauma patients. Transfusion. 2018 Oct;58(10):2280-2288. doi: 10.1111/trf.14771. Epub 2018 May 25. PMID: 29802644. |
| 16 |  | | | The Near Disappearance of Fetal Hydrops In Relation to Current State-of-the-Art Management of Red Cell Autoimmunization. |
| Prenatal Diag | 11/01/18 | Severe alloimmune hydrops, a formerly often lethal condition, has practically disappeared, most likely as a result of the introduction of routine early alloantibody screening, use of national guidelines, and pooling of expertise in national reference laboratories and a referral center for fetal therapy. | Females/OB | | Zwiers C, Opkes D, Lopriore E, et al: The Near Disappearance of Fetal Hydrops In Relation to Current State-of-the-Art Management of Red Cell Autoimmunization. Prenatal Diag, 2018; 943-50 |
| 17 | | | | The Dead Sea needs salt water… massively bleeding patients need whole blood: The evolution of blood product resuscitation |
| Transfusions Clin Biol | 06/15/19 | Review paper of advantages of Whole blood compared to component therapy | Trauma | | Seheult JN, Bahr MP, Spinella PC, Triulzi DJ, Yazer MH. The Dead Sea needs salt water… massively bleeding patients need whole blood: The evolution of blood product resuscitation. Transfus Clin Biol. 2019 Sep;26(3):174-179. doi: 10.1016/j.tracli.2019.06.003. Epub 2019 Jun 15. PMID: 31262629. |
| 18 | | | | Cold-stored whole blood: A better method of trauma resuscitation? |
| J Trauma Acute Care Surg | 11/01/19 | Cold-stored whole blood offers the benefit of a balanced resuscitation with improved trauma bay survival(8.8% vs. 2.2%;p = 0.039)and higher mean hemoglobin at 24 hours. | Trauma | | Hazelton JP, Cannon JW, Zatorski C, Roman JS, Moore SA, Young AJ, Subramanian M, Guzman JF, Fogt F, Moran A, Gaughan J, Seamon MJ, Porter J. Cold-stored whole blood: A better method of trauma resuscitation? J Trauma Acute Care Surg. 2019 Nov;87(5):1035-1041. doi: 10.1097/TA.0000000000002471. PMID: 31389912. |
| 19 | | | | Resident Eagle: Whole Blood in the Rural EMS Environment |
| | 01/01/20 | | Non-TraumaPrehospital | | Ebrom, C., Manifold, C., Schaefer R. (2020). Resident Eagle: Whole Blood in the Rural EMS Environment.
https://www.hmpgloballearningnetwork.com/site/emsworld/article/1224535/resident-eagle-whole-bloodrural-ems-environment. |
| 20 | | | | The use of low-titer group O whole blood is independently associated with improved survival compared tocomponent therapy in adults with severe traumatic hemor-rhage. |
| Transfusion | 02/01/20 | | Trauma | | Shea SM, Staudt AM, Thomas KA, Schuerer D, Mielke JE,Folkerts D, et al. The use of low-titer group O whole blood is independently associated with improved survival compared tocomponent therapy in adults with severe traumatic hemor-rhage. Transfusion. 2020;60(S3):S2–9. |
| 21 | | | | From battlefront to homefront: creation of a civilian walking blood bank. |
| Transfusion | 06/01/20 | Outlines a walking blood bank based on pre-screened volunteers | Walking BB | | Braverman MA, Smith A, Shahan CP, Axtman B, Epley E, Hitchman S, Waltman E, Winckler C, Nicholson SE, Eastridge BJ, Stewart RM, Jenkins DH. From battlefront to homefront: creation of a civilian walking blood bank. Transfusion. 2020 Jun;60 Suppl 3:S167-S172. doi: 10.1111/trf.15694. Epub 2020 Jun 1. PMID: 32478857. |
| 22 | | | | Whole blood is superior to component
transfusion for injured children: a propensity
matched analysis. |
| Annals of surgery | 10/01/20 | | Pediatric | | Leeper CM, Yazer MH, Triulzi DJ, Neal MD,
Gaines BA. Whole blood is superior to component
transfusion for injured children: a propensity
matched analysis. Ann Surg. 2020;272(4):590-594.
doi:10.1097/SLA.0000000000004378 |
| 23 | | | | Whole Blood is Superior to Component Transfusion for Injured Children: A Propensity Matched Analysis |
| Ann Surg | 10/01/20 | 3 x faster improvement in base deficit no other significant outcomes | Pediatric | | Leeper CM, Yazer MH, Triulzi DJ, Neal MD, Gaines BA. Whole Blood is Superior to Component Transfusion for Injured Children: A Propensity Matched Analysis. Ann Surg. 2020 Oct;272(4):590-594. doi: 10.1097/SLA.0000000000004378. PMID: 32932312. |
| 24 | | | | Efficacy and Safety of Whole Blood Transfusion
in Non-Trauma Patients |
| American Surgery | 01/01/21 | A total of 237 patients who received WB were identified with 55 (23.2%) non-trauma patients. Eight patients (14.5%) received pre-hospital WB. The most common etiology of non-traumatic hemorrhage was gastrointestinal bleeding (43.6%, n = 24/55). Approximately half of the non-trauma patients (n = 28/55) received component therapy. Transfusion-related events occurred in 3 patients. This study demonstrated that non-trauma patients could receive WB transfusions safely with infrequent transfusion-related events. Future studies should focus on determining if outcomes are improved in non-trauma patients who receive WB transfusions and defining specific transfusion criteria for this population. | Non-Trauma | https://pubmed.ncbi.nlm.nih.gov/34592111/ | Smith, A. A., Alkhateb, R., Braverman, M., Shahan, C. P., Axtman, B., Nicholson, S., Greebon, L., Eastridge, B., Jonas, R.
B., Stewart, R., Schaefer, R., Foster, M., & Jenkins, D. (2021). Efficacy and Safety of Whole Blood Transfusion
in Non-Trauma Patients. Am Surg, 31348211048831. https://doi.org/10.1177/00031348211048831. |
| 25 | | | | The Use of Whole Blood Transfusion During Non-Traumatic Resuscitation |
| Military Medicine | 01/01/21 | | Non-Trauma | | Nowadly, C. D., Fisher, A. D., Borgman, M. A., Mdaki, K. S., Hill, R. L., Nicholson, S. E., Bynum, J. A., & Schauer, S. G.
(2021). The Use of Whole Blood Transfusion During Non-Traumatic Resuscitation. Military Medicine, 187(7-
8), e821-e825. https://doi.org/10.1093/milmed/usab128. |
| 26 | | | | Rate of RhD-alloimunization after the transfusion of RhD-positive red blood cell containing products among injured patients of child-bearing age: single center experience and narrative literature review |
| Hematology | 05/01/21 | 42.7% Rh-D alloimmunization 94% of the population studies were male | Females/OB | | Yazer M, Triulzi D, Sperry J, et al: Rate of RhD-alloimunization after the transfusion of RhD-positive red blood cell containing products among injured patients of child-bearing age: single center experience and narrative literature review: Hematology,2021;26(1)321-7. |
| 27 | | | | Civilian walking blood bank emergency preparedness plan |
| Transfusion | 07/01/21 | Suggests walking blood bank should be considered | Walking BB | | Holcomb JB, Spinella PC, Apelseth TO, Butler FK, Cannon JW, Cap AP, Corley JB, Doughty H, Fitzpatrick M, Goldkind SF, Gurney JM, Homer MJ, Ilstrup SJ, Jansen JO, Jenkins DH, Marques MB, Moore EE, Ness PM, O'Connor KC, Schreiber MA, Shinar E, Sloan S, Strandenes G, Stubbs JR, Taylor AL, Ward KR, Waltman E, Yazer M. Civilian walking blood bank emergency preparedness plan. Transfusion. 2021 Jul;61 Suppl 1:S313-S325. doi: 10.1111/trf.16458. PMID: 34269450. |
| 28 | | | | Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program consensus statement on whole blood |
| Transfusion | 07/01/21 | Position statement: outlines the military's endorsement of whole blood1) whole blood should be used to treat hemorrhagic shock; (2) low-titer group O whole blood is the resuscitation product of choice for the treatment of hemorrhagic shock for all casualties at all roles of care; (3) whole blood should be available within 30 min of casualty wounding, on all medical evacuation platforms, and at all resuscitation and surgical team locations; (4) when whole blood is not available, component therapy should be available within 30 min of casualty wounding; (5) all prehospital medical providers should be trained and logistically supported to screen donors, collect fresh whole blood from designated donors, transfuse blood products, recognize and treat transfusion reactions, and complete the minimum documentation requirements; (6) all deploying military personnel should undergo walking blood bank prescreen laboratory testing for transfusion transmitted disease immediately prior to deployment. Those who are blood group O should undergo anti-A/anti-B antibody titer testing. | MilitaryTrauma | | Shackelford SA, Gurney JM, Taylor AL, Keenan S, Corley JB, Cunningham CW, Drew BG, Jensen SD, Kotwal RS, Montgomery HR, Nance ET, Remley MA, Cap AP; Joint Trauma System Defense Committee on Trauma; Armed Services Blood Program. Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program consensus statement on whole blood. Transfusion. 2021 Jul;61 Suppl 1:S333-S335. doi: 10.1111/trf.16454. PMID: 34269445. |
| 29 | | | | Whole blood transfusion reduces overall component transfusion in cases of placenta accreta spectrum: a pilot program |
| The Journal of Maternal-Fetal & Neonatal Medicine | 07/01/21 | | Females/OB | | Munoz, J. L., Kimura, A. M., Xenakis, E., Jenkins, D. H., Braverman, M. A., Ramsey, P. S., & Ireland, K. E. (2021). Whole blood transfusion reduces overall component transfusion in cases of placenta accreta spectrum: a pilot program. The Journal of Maternal-Fetal & Neonatal Medicine, 1-6. https://doi.org/10.1080/14767058.2021.1915275. |
| 30 | | | | THOR-AABB Working Party Recommendations for a Prehospital Blood Product Transfusion Program |
| Prehospital Emergency Care | 08/01/21 | These recommendations cover all aspects of such a program including storing, transporting, and transfusing blood products in the prehospital phase of hemorrhagic resuscitation. | Operational HowPrehospital | https://www.tandfonline.com/doi/full/10.1080/10903127.2021.1995089#abstract | Yazer, M. H., Spinella, P. C., Bank, E. A., Cannon, J. W., Dunbar, N. M., Holcomb, J. B., Jackson, B. P., Jenkins, D., Levy, M., Pepe, P. E., Sperry, J. L., Stubbs, J. R., & Winckler, C. J. (2021). THOR-AABB Working Party
Recommendations for a Prehospital Blood Product Transfusion Program. Prehospital Emergency Care, 1-13.
https://doi.org/10.1080/10903127.2021.1995089 |
| 31 | | | | Can RH+ whole blood be safely used as an alternative to RH- product? An analysis of efforts to improve the sustainability of a hospital's low titer group O whole blood program |
| JTACS | 10/01/21 | When Rh- whole blood is unavailable or in short supply, Rh+ LTO-WB appears to be a safe alternative for the resuscitation of hemorrhagic shock in both Rh+ and Rh- patients. Use of Rh+ product may help trauma centers incorporate LTO-WB into their hospital and improve sustainability of such programs. | Females/OBRh/ABO incompatibilityTrauma | | McCoy CC, Montgomery K, Cotton ME, Meyer DE, Wade CE, Cotton BA. Can RH+ whole blood be safely used as an alternative to RH- product? An analysis of efforts to improve the sustainability of a hospital's low titer group O whole blood program. J Trauma Acute Care Surg. 2021 Oct 1;91(4):627-633. doi: 10.1097/TA.0000000000003342. PMID: 34238860. |
| 32 | | | | THOR-AABB Working Party
Recommendations for a Prehospital Blood
Product Transfusion Program |
| Prehospital Emergency Care | 11/19/21 | The evidence for the lifesaving benefits of prehospitaltransfusions is increasing. As such, emergency medicalservices (EMS) might increasingly become interested inproviding this important intervention. While a few EMSand air medical agencies have been providing exclusivelyred blood cell (RBC) transfusions to their patients formany years, transfusing plasma in addition to the RBCs,or simply using low titer group O whole blood (LTOWB | Prehospital | | Yazer, et al; |
| 33 | | | | Providing whole blood for an urban paramedical ambulance system |
| Transfusion | 01/01/22 | Over a 1-year period beginning August 27, 2019, 160 units of whole blood were made available for use, and 51 units were transfused to 39 patients, 30 of whom were trauma patients. Other recipients include patients in shock from massive gastrointestinal, peripartum, or other suspected bleeding. Unused units were returned to the providing transfusion service after 1 week and used for hospital patient care without loss. The estimated cost of providing blood per mission was $0.28 and per patient transfused was $1138. | Prehospital | | Sayre MR, Yang BY, Murphy DL, Counts CR, Dang M, Ubaldi P, Tuott EE, Hess JR. Providing whole blood for an urban paramedical ambulance system. Transfusion. 2022 Jan;62(1):82-86. doi: 10.1111/trf.16749. Epub 2021 Nov 17. PMID: 34787330. |
| 34 | | | | Whole blood at the tip of the spear: A retrospective cohort analysis of warm fresh whole blood resuscitation versus component therapy in severely injured combat casualties |
| Surgery | 02/01/22 | The adjusted odds ratio of 6-hour mortality was 0.27 (95% confidence interval 0.13-0.58) for the warm fresh whole blood versus non-warm fresh whole blood group. The reduction in mortality increased in magnitude (odds ratio = 0.15, P = .024) among the subgroup of 422 patients with complete data allowing adjustment for seven additional covariates. There was a dose-dependent effect of warm fresh whole blood, with patients receiving higher warm fresh whole blood dose (>33% of red blood cell-containing units) having significantly lower mortality versus the non-warm fresh whole blood group. | Trauma | | Gurney JM, Staudt AM, Del Junco DJ, Shackelford SA, Mann-Salinas EA, Cap AP, Spinella PC, Martin MJ. Whole blood at the tip of the spear: A retrospective cohort analysis of warm fresh whole blood resuscitation versus component therapy in severely injured combat casualties. Surgery. 2022 Feb;171(2):518-525. doi: 10.1016/j.surg.2021.05.051. Epub 2021 Jul 10. PMID: 34253322. |
| 35 | | | | Impact of Incorporating Whole Blood into
Hemorrhagic Shock Resuscitation: Analysis of 1,377
Consecutive Trauma Patients Receiving Emergency-
Release Uncrossmatched Blood Products |
| JTACS | 04/01/22 | In patients experiencing hemorrhagic shock, WB transfusion is associated with both improved
survival and decreased overall blood utilization. | CostTrauma | https://journals.lww.com/journalacs/fulltext/2022/04000/impact_of_incorporating_whole_blood_into.2.aspx | Brill, J. B., Tang, B., Hatton, G., Mueck, K. M., McCoy, C. C., Kao, L. S., & Cotton, B. A. (2022). Impact of Incorporating Whole Blood into Hemorrhagic Shock Resuscitation: Analysis of 1,377 Consecutive Trauma Patients Receiving Emergency-Release Uncrossmatched Blood Products. Journal of the American College of Surgeons, 234(4), 408–418. https://doi.org/10.1097/XCS.0000000000000086 |
| 36 | | | | The Role of Whole Blood Transfusions in Civilian Trauma: A review of Literature in Military and Civilian Trauma |
| Cureus | 04/18/22 | | Trauma | | Kronstedt S, Lee J, Millner D, et al. (April 18, 2022) The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. Cureus 14(4): e24263. DOI 10.7759/cureus.24263 |
| 37 | | | | The Use of Whole Blood in Rural Trauma Leads to Decreased Resource Utilization |
| The American Surgeon | 07/01/22 | Results
Forty patients received WB vs. 153 HC. WB patients had lower complication rates (35% vs. 55.6%; P = .02), and a significant reduction in pRBC utilization in the emergency department (0 vs. 2; P < .0001) and throughout admission (2.0 vs. 4.0; P = .0003). All patients had prolonged transport times given the rural setting (1.42 hours HC vs. 2.03 hours WB; P = .002).
Discussion
Unlike most urban WB studies, this study occurred in a rural area with extended transportation times, when WB is inaccessible for patients. Despite this delay, WB patients demonstrated lower component utilization and complication rates. Further research is needed to characterize the impact of early WB access. | CostRural | https://journals.sagepub.com/doi/10.1177/00031348221142584 | Niemann, B. R., Grabo, D. J., Mullens, C., Shmookler, A. D., Lopez, S., Lander, O. M., Griffin, P. L., & Bardes, J. M.
(2022). The Use of Whole Blood in Rural Trauma Leads to Decreased Resource Utilization. The American
surgeon, 31348221142584. Advance online publication. https://doi.org/10.1177/00031348221142584. |
| 38 | | | | Rate of D-alloimmunization in trauma does not depend on the number of RhD-positive units transfused: The BEST collaborative study |
| Transfusion | 08/01/22 | the rate of D-alloimmunization was not significantly different between those who received one RhD-positive unit and those who received multiple RhD-positive units. | Females/OB | | Seheult JN, Callum J, Delaney M, Drake R, Dunbar NM, Harm SK, Hess JR, Jackson BP, Javanbakht A, Moore SA, Murphy MF, Raval JS, Staves J, Tuott EE, Wendel S, Ziman A, Yazer MH; Biomedical Excellence for Safer Transfusion collaborative. Rate of D-alloimmunization in trauma does not depend on the number of RhD-positive units transfused: The BEST collaborative study. Transfusion. 2022 Aug;62 Suppl 1:S185-S192. doi: 10.1111/trf.16952. Epub 2022 Jun 24. PMID: 35748692. |
| 39 | | | | The Norwegian blood preparedness project: A whole blood program including civilian walking blood banks for early treatment of patients with life-threatening bleeding in municipal health care services, ambulance services, and rural hospital |
| Transfusion | 08/01/22 | Discusses a feasibility plan for a country-wide walking blood bank plan in Norway | Walking BB | | Apelseth TO, Arsenovic M, Strandenes G. The Norwegian blood preparedness project: A whole blood program including civilian walking blood banks for early treatment of patients with life-threatening bleeding in municipal health care services, ambulance services, and rural hospitals. Transfusion. 2022 Aug;62 Suppl 1(Suppl 1):S22-S29. doi: 10.1111/trf.16968. Epub 2022 Jun 25. PMID: 35751878; PMCID: PMC9543315. |
| 40 | | | | Use of Cold-Stored Whole Blood is Associated With Improved
Mortality in Hemostatic Resuscitation of Major Bleeding |
| Annals of Surgery | 10/01/22 | Compared with BCT, the use of WB was associated with a
48% reduction in mortality in trauma patients. Our study supports the
use of WB use in the resuscitation of trauma patients. | Trauma | | 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. |
| 41 | | | | Resuscitative practices and the use of low-titer group O whole blood in pediatric trauma |
| Journal of Trauma and Acute Care Surgery | 01/01/23 | Whole blood is an efficient way to achieve balanced resuscitation in critically injured children. Administration of cold-stored, low titer group O negative whole blood appears to be safe and may be associated with a survival advantage in pediatric trauma. | Pediatric | | Morgan, Katrina M. MD; Leeper, Christine M. MD, MS; Yazer, Mark H. MD; Spinella, Philip C. MD; Gaines, Barbara A. MD. Resuscitative practices and the use of low-titer group O whole blood in pediatric trauma. Journal of Trauma and Acute Care Surgery 94(1S):p S29-S35, January 2023. | DOI: 10.1097/TA.0000000000003801 |
| 42 | | | | Time is tissue: Barriers to timely
transfusion after pediatric injury |
| J Trauma Acute Care Surg | 01/01/23 | Several strategies improve outcomes among injured children who require transfusion but barriers to their timely use has received little attention. We identify and describe the necessary steps to ensure timely transfusion and propose practices to minimize barriers in this process. | Pediatric | | Sullivan, T. M., Gestrich-Thompson, W. V., Milestone, Z. P., & Burd, R. S. (2023). Time is tissue: Barriers to timely
transfusion after pediatric injury. J Trauma Acute Care Surg, 94(1S Suppl 1), S22-S28.
https://doi.org/10.1097/TA.0000000000003752 |
| 43 | | | | time to early resuscitative intervention association with mortality in trauma patients att risk for hemorrhage |
| J Trauma acute care surg | 01/11/23 | 2% increase in 24-hour and 30 day mortality per minute from time of paramedic contact unit initiation of transfusion therapies | PrehospitalTrauma | https://pmc.ncbi.nlm.nih.gov/articles/PMC10038862/ | Deeb AP, Guyette FX, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Eastridge BJ, Joseph B, Nirula R, Vercruysse GA, Sperry JL, Brown JB. Time to early resuscitative intervention association with mortality in trauma patients at risk for hemorrhage. J Trauma Acute Care Surg. 2023 Apr 1;94(4):504-512. doi: 10.1097/TA.0000000000003820. Epub 2023 Jan 11. PMID: 36728324; PMCID: PMC10038862. |
| 44 | | | | Association of whole blood with
survival among patients presenting with severe
hemorrhage in US and Canadian adult civilian
trauma centers. |
| JAMA Surgery | 01/18/23 | In this cohort study, receipt of WB-MTP was associated with improved survival in trauma patients presenting with severe hemorrhage, with a survival benefit found early after transfusion. The findings from this study are clinically important as this is an essential first step in prioritizing the selection of WB-MTP for trauma patients presenting with severe hemorrhage. | Trauma | | Torres CM, Kent A, Scantling D, Joseph B, Haut
ER, Sakran JV. Association of whole blood with
survival among patients presenting with severe
hemorrhage in US and Canadian adult civilian
trauma centers. JAMA Surg. Published online January
18, 2023. doi:10.1001/jamasurg.2022.6978 |
| 45 | | | JAMA Surgery | 01/18/23 | Commentary | | | |
| 46 | | | | Transfusion-related cost comparison of trauma patients receiving whole blood versus component therapy. |
| J. Trauma Acute Care Surgery | 02/01/23 | With increased use of LTO+WB for resuscitation, cost comparison is of significant importance to all stakeholders. Low titer O+
WB was associated with reduced cost in severely injured patients. Ongoing analyses may improve resource utilization and benefit
overall healthcare cost. (J Trauma Acute Care Surg. 2023;95: 62–68. Copyright © 2023 Wolters Kluwer Health, Inc. All rights
reserved.) | Cost | https://journals.lww.com/jtrauma/abstract/2023/07000/transfusion_related_cost_comparison_of_trauma.10.aspx | Ciaraglia A, Myers J, Braverman M. Transfusion-related cost comparison of trauma patients receiving whole blood versus component therapy. J Trauma Acute Care Surg. 2023 March; 95(1); 62-68. DOI: 10.1097/TA.0000000000003933 |
| 47 | | | | Is Low-Titer Group O Whole Blood Truly a Universal Blood Product? |
| JACS | 03/01/23 | LTOWB appears to be a safe product for universal use across all blood groups. Group B recipients arrived with worse physiologic values associated with hemorrhagic shock whether receiving LTOWB or standard component products. | Non-TraumaRh/ABO incompatibility | https://journals.lww.com/journalacs/fulltext/2023/03000/is_low_titer_group_o_whole_blood_truly_a_universal.9.aspx | Brill JB, Mueck KM, Tang B, Sandoval M, Cotton ME, Cameron McCoy C, Cotton BA. Is Low-Titer Group O Whole Blood Truly a Universal Blood Product? J Am Coll Surg. 2023 Mar 1;236(3):506-513. doi: 10.1097/XCS.0000000000000489. Epub 2022 Nov 28. PMID: 36730210. |
| 48 | | | | Outcomes of Transfusion With Whole Blood,
Component Therapy, or Both in Adult Civilian
Trauma Patients: A Systematic Review and
Meta-Analysis |
| Journal of Surgical Reserarch | 03/20/23 | Transfusion with WB þ COMP is associated with lower 24-h mortality versus COMP and transfusion with WB is associated with a lower volume of red blood cells transfused at both 6 and 24 h. Based on these findings, greater utilization of whole blood in civilian adult trauma resuscitation may lead to improved mortality and reduced transfusion requirements. | Trauma | | Ngatuvai M, Zagales I, Sauder M, Andrade R, Santos RG, Bilski T, Kornblith L, Elkbuli A. Outcomes of Transfusion With Whole Blood, Component Therapy, or Both in Adult Civilian Trauma Patients: A Systematic Review and Meta-Analysis. J Surg Res. 2023 Jul;287:193-201. doi: 10.1016/j.jss.2023.02.010. Epub 2023 Mar 20. PMID: 36947979. |
| 49 | | | | Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion |
| Ann Surg | 04/01/23 | LTOWB group had improved survival at 72 hours and 28 days, not significantly improved at 6-hours AOR 0.23 p<0.02, 28 day had reduced hospital cost, Length of stay, ICU days and ventilator days | Pediatric | | Gaines BA, Yazer MH, Triulzi DJ, Sperry JL, Neal MD, Billiar TR, Leeper CM. Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion. Ann Surg. 2023 Apr 1;277(4):e919-e924. doi: 10.1097/SLA.0000000000005251. Epub 2021 Oct 8. PMID: 35129530. |
| 50 | | | ACS news article | 04/10/23 | | | | |
| 51 | | | | ACS Whole Blood Video (2 min) |
| NA (YouTube) | 04/10/23 | Whole blood should be the standard for resuscitation in hemorrhagic shock | Trauma | | |
| 52 | | | | Implementation of a low-titer stored whole blood transfusion program for civilian trauma patients: Early experience and logistical challenges |
| Injury | 05/01/23 | A total of 177 units of LTOWB were purchased during the study period, and of those, 74 (42%) expired before use.Patients who received LTOWB had a similar mortality compared to those who received component therapy (39% vs. 47%; Odds Ratio [95% CI]: 0.7 [0.3, 2.0]; p = 0.72,) however, they were able to achieve a significantly higher plasma:pRBC ratio during the duration of MTP activation | Trauma | | Barmparas G, Huang R, Hayes C, Pepkowitz SH, Abumuhor IA, Thomasian SE, Margulies DR, Klapper EB. Implementation of a low-titer stored whole blood transfusion program for civilian trauma patients: Early experience and logistical challenges. Injury. 2022 May;53(5):1576-1580. doi: 10.1016/j.injury.2022.01.043. Epub 2022 Jan 31. PMID: 35123798. |
| 53 | | | | 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. |
| Journal of Am Coll Surg | 05/01/23 | No significant change in 4-hour mortality, but when there was an increased risk of prehospital mortality there was a 48% reduction in 4-hour mortality and a 30% reduction in 30-day mortality. Differences became significant at 5% increased risk of prehospital death at 4 hours and at 10% for the 30-day group | Trauma | https://www.life-assist.com/Content/Docs/wholeBloodResus.pdf | 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 Apr 11. doi: 10.1097/XCS.0000000000000708. Epub ahead of print. PMID: 37039365. |
| 54 | | | | Whole Blood Resuscitation and Association with Survival in Injured Patients with an
Elevated Probability of Mortality |
| | 05/01/23 | Conclusion: Early LTOWB resuscitation is safe but not independently associated with survival
for the overall enrolled population. When patients were selected with an elevated probability of
mortality based upon prehospital injury characteristics, LTOWB was independently associated
with a lower risk of mortality starting at 4 hours post arrival thru 28 days post-injury.30-48% | Trauma | https://pmc.ncbi.nlm.nih.gov/articles/PMC10344433/ | 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 Apr 11. doi: 10.1097/XCS.0000000000000708. Epub ahead of print. PMID: 37039365. |
| 55 | | | | FRETAC Whole Blood Committee
Position Paper on the Use of Whole Blood Compared to Component Therapy |
| Unpublished | 05/08/23 | White paper and reference list | | | Branney |
| 56 | | | | Prehospital whole blood reduces early mortality in patients with hemorrhagic shock. |
| Transfusion | 07/01/23 | transfused group had worse SI (1.25 vs 0.95 p<0.01. greater reversal in shock upon arrival (0.28 vs 0.002) 7% reduction in early mortality | PrehospitalTrauma | | Braverman MA, Smith A, Pokorny D, Axtman B, Shahan CP, Barry L, Corral H, Jonas RB, Shiels M, Schaefer R, Epley E, Winckler C, Waltman E, Eastridge BJ, Nicholson SE, Stewart RM, Jenkins DH. Prehospital whole blood reduces early mortality in patients with hemorrhagic shock. Transfusion. 2021 Jul;61 Suppl 1:S15-S21. doi: 10.1111/trf.16528. PMID: 34269467. |
| 57 | | | | Risk factors for massive transfusion in obstetrical hemorrhage and consideration of a whole blood program |
| Transfusion | 07/01/23 | | Females/OB | | Myers, JC, Braverman, MA, Ciaraglia, A, Alkhateb, R, Barry, L, Brooke, Z, et al. Risk factors for massive transfusion in obstetrical hemorrhage and consideration of a whole blood program. Transfusion. 2023. https://doi.org/10.1111/trf.17331 |
| 58 | | | | The impact of prehospital whole blood on hemorrhaging trauma patients: A multi-center retrospective study |
| Journal of Trauma and Acute Care Surgery | 08/01/23 | Prehospital WB administration is associated with a greater improvement in SI and a reduction in MTP. This study is limited by its lack of power to detect a mortality difference. Prospective randomized controlled trials will be required to determine the true impact of pWB on trauma patients. | Trauma | | Braverman, M. A., Schauer, S. G., Ciaraglia, A., Brigmon, E., Smith, A. A., Barry, L., Bynum, J., Cap, A. D., Corral, H., Fisher, A. D., Epley, E., Jonas, R. B., Shiels, M., Waltman, E., Winckler, C., Eastridge, B. J., Stewart, R. M., Nicholson, S. E., & Jenkins, D. H. (2023). The impact of prehospital whole blood on hemorrhaging trauma patients: A multi-center retrospective study. The journal of trauma and acute care surgery, 95(2), 191–196. https://doi.org/10.1097/TA.0000000000003908 |
| 59 | | | | Stewardship of Prehospital Low Titer O-positve Whole Blood in a Large Urban Fire-Based EMS System |
| Prehospital Emerg Care | 11/22/23 | 1 year retrospective review of San Antonio Fire use of whole blood use , they got 363 units and used 248 were transfused (68.3%) No wastage | Prehospital | | Bullock W, Schaefer R, Wampler D, Stringfellow M, Dieterle M, Winckler CC. Stewardship of Prehospital Low Titer O-Positive Whole Blood in a Large Urban Fire-Based EMS System. Prehosp Emerg Care. 2022 Nov-Dec;26(6):848-854. doi: 10.1080/10903127.2021.1992052. Epub 2021 Nov 22. PMID: 34644237. |
| 60 | | | | Not as "D"eadly as once thought - the risk of D-alloimmunization and hemolytic disease of the fetus and newborn following RhD-positive transfusion in trauma |
| Hematology | 12/01/23 | Risk of fetal death from HDFN ranges from 0-6.5% after D-alloimmunization risk of death from severe hemorrhagic shock 24% | Females/OB | | Yazer MH, Panko G, Holcomb JB, Kaplan A, Leeper C, Seheult JN, Triulzi DJ, Spinella PC. Not as "D"eadly as once thought - the risk of D-alloimmunization and hemolytic disease of the fetus and newborn following RhD-positive transfusion in trauma. Hematology. 2023 Dec;28(1):2161215. doi: 10.1080/16078454.2022.2161215. PMID: 36607150. |
| 61 | | | | Use of whole blood in pediatric trauma: a narrative review |
| Trauma Surgery & Acute Care Open | 01/05/24 | In this study, we reviewed data regarding the use, safety, and outcomes of LTOWB transfusion in patients with pediatric trauma. Transfusion of LTOWB in children was shown to be safe; no studies reported hemolysis, increased organ failure, or transfusion reactions. Some clinical outcomes differed between LTOWB and CT recipients, including decreased transfusion volumes and improvement in biochemical markers of shock and TIC after receipt of LTOWB. A survival advantage was shown in massively transfused injured children only, though the other studies included in this review were largely underpowered to detect a difference in mortality. Recent guidelines developed by a group of experts in pediatric trauma resuscitation recommended clinicians should consider transfusing low titer (≤200 anti-A and anti-B immunoglobulin G) group O whole blood to resuscitate traumatically injured children in hemorrhagic shock if available over individual component blood products.31 Large, well-designed multicenter studies are needed. | Pediatric | https://pmc.ncbi.nlm.nih.gov/articles/PMC10773435/ | Abou Khalil E, Morgan KM, Gaines BA, Spinella PC, Leeper CM. Use of whole blood in pediatric trauma: a narrative review. Trauma Surg Acute Care Open. 2024 Jan 5;9(Suppl 1):e001127. doi: 10.1136/tsaco-2023-001127. PMID: 38196932; PMCID: PMC10773435. |
| 62 | | | | Doing more with less: low-titer group O wholeblood resulted in less total transfusions and an independent association with survival in adults with severe traumatic hem-orrhage. |
| J Thromb Haemost. | 02/01/24 | | Trauma | | Shea SM, Mihalko EP, Lu L, Thomas KA, Schuerer D,Brown JB, et al. Doing more with less: low-titer group O wholeblood resulted in less total transfusions and an independentassociation with survival in adults with severe traumatic hem-orrhage. J Thromb Haemost. 2024;22:140–51. |
| 63 | | | | Use of Low-Titer O-Positive Whole Blood in Female Trauma Patients: A Literature Review, Qualitative Multidisciplinary Analysis of Risk/Benefit, and Guidelines for Its Use as a Universal Product in Hemorrhagic Shock |
| JACS | 03/01/24 | The use of whole blood resuscitation in trauma is associated with benefits in the resuscitation of severely injured patients. The rate at which severely injured, Rh-negative patients develop anti-D antibodies is low. Treatments for alloimmunized pregnancies have advanced, with excellent results. Fears of alloimmunization in female patients are likely overstated and may not warrant the withholding of whole blood resuscitation. The benefits of whole blood resuscitation likely outweigh the risks of alloimmunization. | Females/OB | https://pubmed.ncbi.nlm.nih.gov/37930900/ | Clements, Thomas W MD, FRCSC; Van Gent, Jan-Michael DO, FACS; Menon, Neethu MD; Roberts, Aaron MD; Sherwood, Molly BS; Osborn, Lesley MD; Hartwell, Beth MD; Refuerzo, Jerrie MD; Bai, Yu MD; Cotton, Bryan A MD, MPH, FACS. Use of Low-Titer O-Positive Whole Blood in Female Trauma Patients: A Literature Review, Qualitative Multidisciplinary Analysis of Risk/Benefit, and Guidelines for Its Use as a Universal Product in Hemorrhagic Shock. Journal of the American College of Surgeons 238(3):p 347-357, March 2024. | DOI: 10.1097/XCS.0000000000000906 |
| 64 | | | | Impact of Prehospital Exsanguinating Airway-Breathing-Circulation Resuscitation Sequence on Patients with Severe Hemorrhage |
| Journal of the American College of Surgeons | 04/01/24 | This is the first analysis to demonstrate a prehospital survival benefit of x-ABC in this subset of patient with severe injury and hemorrhagic shock. Standardization of prehospital x-ABC management in this patient population warrants special consideration. | PrehospitalTrauma | https://journals.lww.com/journalacs/abstract/2024/04000/impact_of_prehospital_exsanguinating.2.aspx | Chio, J. C. T., Piehl, M., De Maio, V. J., Simpson, J. T., Matzko, C., Belding, C., Broome, J. M., & Duchesne, J. (2023). A circulation-first approach for resuscitation of trauma patients with hemorrhagic shock. Shock (Augusta, Ga.), 59(1), 1-4. https://doi.org/10.1097/shk.0000000000002028 |
| 65 | | | | Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients |
| JAMA Surgery | 04/01/24 | In this cohort study, receipt of a WB transfusion earlier at any time point within the first 24 hours of ED arrival was associated with improved survival in patients presenting with severe hemorrhage. The survival benefit was noted shortly after transfusion. The findings of this study are clinically important as the earlier timing of WB administration may offer a survival advantage in actively hemorrhaging patients requiring MTP. | PrehospitalTiming | https://pubmed.ncbi.nlm.nih.gov/38294820/ | Torres CM, Kenzik KM, Saillant NN, et al. Timing to First Whole Blood Transfusion and Survival Following Severe
Hemorrhage in Trauma Patients. JAMA Surg. 2024;159(4):374–381. doi:10.1001/jamasurg.2023.7178 |
| 66 | | | | Receipt of RhD-positive whole blood for life-threatening bleeding in female children: A survey in alloimmunized mothers regarding minimum acceptable survival benefit relative to risk of maternal alloimmunization to anti-D |
| Transfusion | 05/01/24 | Alloimmunized mothers would accept the risk of D-alloimmunization in a RhD-negative female child for improved survival in cases of life-threatening bleeding. | Females/OB | | Sherwood MR, Clayton S, Leeper CM, Yazer M, Moise KJ Jr, Granger ME, Spinella PC. Receipt of RhD-positive whole blood for life-threatening bleeding in female children: A survey in alloimmunized mothers regarding minimum acceptable survival benefit relative to risk of maternal alloimmunization to anti-D. Transfusion. 2024 May;64 Suppl 2:S100-S110. doi: 10.1111/trf.17807. Epub 2024 Apr 2. PMID: 38563495. |
| 67 | | | | Use of low titer O whole blood in infants and young children undergoing cardiac surgery with cardiopulmonary bypass |
| Transfusion | 06/21/24 | The use of LTOWB appears to be safe in <2 years old undergo-ing cardiac surgery and may reduce re-explorations for severe bleeding. Largetrials are needed to determine the efficacy and safety of LTOWB in this popula-tion with severe bleeding. | Non-TraumaPediatric | | Griselli M, Said SM, Spinella PC, Evans M, Cohn CS, Joyner N, et al. Use of low titer O whole blood in infants and young children undergoing cardiac surgery with cardiopulmonary bypass. Transfusion. 2024; 64(11): 2075–2085. https://doi.org/10.1111/trf.18014 |
| 68 | | | | Another piece of the hemolytic disease of the fetus and newborn puzzle after RhD-positive transfusion in trauma resuscitation: the
proportion of pregnant women who produce high titer anti-D |
| Trauma Surgery and Acute Care Open | 07/01/24 | | Females/OB | | Mark, H. Y., Stephen, P. E., Darrell, J. T., Philip, S., & Christine, L. (2024). Another piece of the hemolytic
disease of the fetus and newborn puzzle after RhD-positive transfusion in trauma resuscitation: the
proportion of pregnant women who produce high titer anti-D. Trauma Surgery &amp; Acute Care
Open, 9(Suppl 1), e001252. https://doi.org/10.1136/tsaco-2023-001252 |
| 69 | | | | Implementation of a prehospital whole blood program: Lessons
learned |
| Journal of the American College of Emergency Physicians open | 07/01/24 | | Operational HowPrehospital | | Levy, M. J., Garfinkel, E. M., May, R., Cohn, E., Tillett, Z., Wend, C., Sikorksi, R. A., Troncoso, R., Jr, Jenkins, J. L., Chizmar, T. P., & Margolis, A. M. (2024). Implementation of a prehospital whole blood program: Lessons learned. Journal of the American College of Emergency Physicians open, 5(2), e13142. https://doi.org/10.1002/emp2.13142 |
| 70 | | | | Removing the barriers to prehospital blood: A roadmap to success. |
| Journal of Trauma and Acute Care Surgery | 07/01/24 | | Operational HowPrehospital | | Schaefer, R. M., Bank, E. A., Krohmer, J. R., Haskell, A., Taylor, A. L., Jenkins, D. H., & Holcomb, J. B. (2024). Removing
the barriers to prehospital blood: A roadmap to success. The journal of trauma and acute care surgery, 97(2S
Suppl 1), S138–S144. https://doi.org/10.1097/TA.0000000000004378 |
| 71 | | | | The Role of Whole Blood Hemostatic Resuscitation in Bleeding Geriatric Trauma Patients |
| J Surg Res | 07/01/24 | Transfusion of WB as an adjunct to CT is associated with improved early and overall mortality in geriatric trauma patients presenting with severe hemorrhage. The findings from this study are clinically important, as this is an essential first step in prioritizing the selection of WB resuscitation for geriatric trauma patients presenting with hemorrhagic shock. | Trauma | | Hosseinpour H, Anand T, Hejazi O, Colosimo C, Bhogadi SK, Spencer A, Nelson A, Ditillo M, Magnotti LJ, Joseph B. The Role of Whole Blood Hemostatic Resuscitation in Bleeding Geriatric Trauma Patients. J Surg Res. 2024 Jul;299:26-33. doi: 10.1016/j.jss.2024.03.050. Epub 2024 Apr 30. PMID: 38692185. |
| 72 | | | | Whole blood: Total blood product ratio impacts survival in injured children |
| JTACS | 10/01/24 | Increased proportions of LTOWB within the total blood product resuscitation was independently associated with survival in injured children. Based on existing data that suggests safety and improved outcomes with whole blood, consideration may be given to increasing the use of LTOWB over CT resuscitation in pediatric trauma resuscitation. | Pediatric | | Feeney EV, Morgan KM, Spinella PC, Gaines BA, Leeper CM. Whole blood: Total blood product ratio impacts survival in injured children. J Trauma Acute Care Surg. 2024 Oct 1;97(4):546-551. doi: 10.1097/TA.0000000000004362. Epub 2024 Apr 30. PMID: 38685485. |
| 73 | | | | An analysis of the effect of low titer O whole blood (LTOWB) proportions for resuscitation after trauma on 6-hour and 24-hour survival |
| Am J Surg | 11/01/24 | In this analysis of TQIP data, patients receiving ≥10 units of PRBC or LTOWB, we found that higher proportions of LTOWB transfusion relative to the total volume of blood products transfused during the first 4 h were associated with improved 24-h, but not 6-h survival. | Trauma | | Fisher AD, April MD, Yazer MH, Wright FL, Cohen MJ, Maqbool B, Getz TM, Braverman MA, Schauer SG. An analysis of the effect of low titer O whole blood (LTOWB) proportions for resuscitation after trauma on 6-hour and 24-hour survival. Am J Surg. 2024 Nov;237:115900. doi: 10.1016/j.amjsurg.2024.115900. Epub 2024 Aug 13. PMID: 39168048. |
| 74 | | | | Every minute matters: Improving outcomes for penetrating trauma through prehospital advanced resuscitative care |
| JTACS | 11/01/24 | Compared with patients with penetrating trauma and hypotension who first received blood after hospital arrival, resuscitation with blood products was started 19 minutes earlier after initiation of a PHB program despite a 5-minute increase in prehospital time. A survival for early PHB use was demonstrated, with an 11% mortality increase for each minute delay to blood administration. Interventions such as PHB may improve patient outcomes by helping capture opportunities to improve trauma resuscitation closer to the point of injury. | PrehospitalTiming | https://journals.lww.com/jtrauma/abstract/2024/11000/every_minute_matters__improving_outcomes_for.8.aspx | Duchesne, J., McLafferty, B. J., Broome, J. M., Caputo, S., Ritondale, J. P., Tatum, D., Taghavi, S., JacksonWeaver, O., Tran, S., McGrew, P., Harrell, K. N., Smith, A., Nichols, E., Dransfield, T., Marino, M., & Piehl, M. (2024). Every minute matters: Improving outcomes for penetrating trauma through prehospital advanced resuscitative care. The journal of trauma and acute care surgery, 10.1097/TA.0000000000004363. Advance online publication. https://doi.org/10.1097/TA.0000000000004363 |
| 75 | | | | Evolution of whole blood trauma resuscitation in childbearing age females: practice patterns and trends |
| Trauma Surgery & Acute Care Open | 12/06/24 | Many institutions transfused LTOWB to CBAFs. Policies regarding RhD product selection varied. Of the total cohort, the proportion of RhD-negative CBAFs who received LTOWB increased over time but remained lower than all other groups. | Females/OB | | Alexandra MP Brito, Mark H Yazer, Jason L Sperry, James F Luther, Stephen R Wisniewski, Frances Guyette, Ernest E Moore, Bryan A Cotton, Laura Vincent, Erin Fox, Jeremy W Cannon, Nicholas Namias, Joseph P Minei, Lee Anne Ammons, Skye Clayton, Martin Schreiber - Evolution of whole blood trauma resuscitation in childbearing age females: practice patterns and trends: Trauma Surgery & Acute Care Open 2024;9:e001587. |
| 76 | | | | The effect of the proportion of low-titer O whole blood for resuscitation in pediatric trauma patients on 6-, 12- and 24-hour survival |
| J Trauma Acute Care Surg | 02/03/25 | Among LTOWB recipients, we found that a strategy of using LTOWB comprising at least 30% of the total transfusion volume within the first 4 hours was associated with improved survival at 6, 12, and 24 hours. | Pediatric | | Petersen EM, Fisher AD, April MD, Yazer MH, Braverman MA, Borgman MA, Schauer SG. The effect of the proportion of low-titer O whole blood for resuscitation in pediatric trauma patients on 6-, 12- and 24-hour survival. J Trauma Acute Care Surg. 2025 Feb 3. doi: 10.1097/TA.0000000000004564. Epub ahead of print. PMID: 39898869. |
| 77 | | | | Nationwide estimates of potential lives saved with prehospital blood transfusions |
| Transfusion | 03/01/25 | Transfusion of pBP offers the potential to save thousands of injured patients lives. Efforts toward making policy-level interventions aimed at increasing the adoption and availability of pBP should be sought. | Prehospital | https://onlinelibrary.wiley.com/doi/10.1111/trf.18174 | Lammers, D. T., Betzold, R., Henry, R., Dilday, J., Conner, J. R., Williams, J. M., McClellan, J. M., Eckert, M. J.,
Jansen, J. O., Kerby, J., Holcomb, J. B., & Hashmi, Z. G. (2025). Nationwide estimates of potential lives
saved with prehospital blood transfusions. Transfusion, 10.1111/trf.18174. Advance online publication.
https://doi.org/10.1111/trf.18174 |
| 78 | | | | Evaluating reimbursement for prehospital blood transfusions: A nationwide survey |
| Transfusion | 03/02/25 | Many patients who receive prehospital blood transfusion are
public health insurance-eligible. Health policy changes to enable government
reimbursement for prehospital blood transfusions would provide critical financial
support for this life-saving intervention. | CostOperational HowPrehospital | https://onlinelibrary.wiley.com/doi/10.1111/trf.18217 | Hurson T, Schaefer R, Carico C, Griffin R, Bank E, Krohmer J, et al. Evaluating reimbursement for prehospital blood transfusions: A nationwide survey. Transfusion. 2025; 65(Suppl. 1): S6–S13. https://doi.org/10.1111/trf.18217 |
| 79 | | | | A prehospital protocol for transfusion of low-titer O-positive whole blood in patients with hemorrhagic shock in Los Angeles County: Modeling the risk of hemolytic disease of the fetus and newborn. |
| Transfusion | 05/01/25 | Results: We estimated that the proposed prehospital transfusion strategy would result on average in one death from HDFN for every 10,000 transfusions in the overall population (95% confidence interval [CI] 6000–25,000) and for every 1800 transfusions in FCPs (95% CI 1000–4300). Based on the projected annual volume of transfusions under LA‐DROP, this would result in one death due to HDFN approximately every 26 years (95% CI 15–64).
Discussion: The estimated per‐transfusion risk of HDFN is similar to previously published work from other populations. The estimated frequency of deaths from HDFN associated with LA‐DROP is lower than some previously published calculations, likely because of narrower eligibility criteria for transfusion. | Females/OBRh/ABO incompatibility | https://pmc.ncbi.nlm.nih.gov/articles/PMC12035986/ | Wilhelm K, Lauer C, Rangwala R, Zadeh T, Spinella PC, Tolles J. A prehospital protocol for transfusion of low-titer O-positive whole blood in patients with hemorrhagic shock in Los Angeles County: Modeling the risk of hemolytic disease of the fetus and newborn. Transfusion. 2025 May;65 Suppl 1(Suppl 1):S313-S319. doi: 10.1111/trf.18184. Epub 2025 Mar 1. PMID: 40022726; PMCID: PMC12035986. |
| 80 | | | | Rethinking the hemorrhagic shock chain of survival: The role, importance, and impact of prehospital blood administration |
| Transfusion | 01/01/26 | The chain of survival concept from prehospital transfusion illustrates the essential components of a system of care and serves as a roadmap to improve outcomes. In this manuscript, we make a case for why such a systematic, evidence-based template for improving outcomes in hemorrhagic shock from both traumatic and non-traumatic causes of bleeding should include prehospital blood administration. Prehospital blood products are a crucial additional link in the hemorrhagic shock chain of survival, and their addition highlights their importance in resuscitating these patients. Ground-based civilian prehospital care for hemorrhagic shock for decades has focused only on stopping the bleeding and rapidly delivering the patient suffering truncal bleeding to a hospital, but now, there is a growing opportunity to replace the blood being lost. Blood is, however, but one link in the entire chain of survival, and success depends on coordinated actions across all links, from bystanders to EMS and through hospital teams. | Prehospital | https://onlinelibrary.wiley.com/doi/10.1111/trf.70082 | Wend CM, Levy MJ, O'Byrne H, Jenkins D, Krohmer JR, Holcomb JB. Rethinking the hemorrhagic shock chain of survival: The role, importance, and impact of prehospital blood administration. Transfusion. 2026;66(Suppl. 1):S114–S123. https://doi.org/10.1111/trf.70082 |
| 81 | | | | The Feasibility and Safety of Prehospital Whole Blood Administration for Patients in Hemorrhagic Shock in Isolated Regions of Colorado: Assessment of the First 6 Months |
| World Journal of Surgery | 02/01/26 | This pilot study demonstrated that prehospital administration of LTOWB in rural regions of Colorado is very infrequent, but feasible, safe, and logistically sustainable. This experience could be considered for implementation of prehospital LTOWB in other rural locations around the world. | PrehospitalRural | https://onlinelibrary.wiley.com/doi/10.1002/wjs.70277 | Branney, Matthew, Sydney Mattox, John Lynch, et al. 2026. “The Feasibility and Safety of Prehospital Whole Blood Administration for Patients in Hemorrhagic Shock in Isolated Regions of Colorado: Assessment of the First 6 Months,” World Journal of Surgery: 50. no. 4), 1097–1100. https://doi.org/10.1002/wjs.70277. |
| 82 | | | | Establishing the Standardized EMS Metrics for Survival in Transfusion and Advanced Resuscitation: the SEMSTAR project |
| Trauma Surgery & Acute Care Open | 03/01/26 | SEMSTAR establishes the first national, consensus-driven framework for standardized data collection and outcome reporting among prehospital blood transfusion programs. By defining core and expanded metrics with standardized survival definitions, this framework enables benchmarking, quality improvement, and multicenter research across diverse EMS systems. SEMSTAR adoption will enable rigorous program evaluation and support the development of a national registry to advance evidence-based care for patients with hemorrhagic shock. | Operational How | https://tsaco.bmj.com/content/11/1/e002217 | Levy MJ, O’Byrne H, Hack K, Staudt A, Crowe R, Bank EA, et al. Establishing the Standardized EMS Metrics for Survival in Transfusion and Advanced Resuscitation: the SEMSTAR project. Trauma Surgery & Acute Care Open. 2026;11:e002217. https://doi.org/10.1136/tsaco-2025-002217 |
| 83 | | | | Transfusion reactions after whole blood transfusion in Norway, 2021–2024: A report from the Norwegian Hemovigilance program |
| Transfusion | 03/01/26 | These findings indicate that WB transfusion in Norway is safe. However, there are inherent risks for blood transfusion in general and also risks more specific to WB transfusion. These include the presence of red blood cell alloantibodies anti-A and anti-B combined with approximately 250 mL plasma from a single donor. Accurate and timely hemovigilance work is important to safeguard patient outcomes and provide a foundation for targeted risk mitigation strategies for WB transfusion. | Non-TraumaSafetyTrauma | https://onlinelibrary.wiley.com/doi/abs/10.1111/trf.70193 | Erikstein BS, Titze TL, Jacobsen B, Hervig T, Engum A, Apelseth TO, et al. Transfusion reactions after whole blood transfusion in Norway, 2021–2024: A report from the Norwegian Hemovigilance program. Transfusion. 2026;66(6):1099–1107. https://doi.org/10.1111/trf.70193 |
| 84 | | | | Whole-Blood vs Component Therapy in Adult Trauma
An Updated Systematic Review and Meta-Analysis |
| JAMA Surgery | 03/01/26 | In this updated systematic review and meta-analysis, whole-blood transfusion was associated with reduced mortality in civilian but not military adult trauma patients, although the wide 95% PIs suggest substantial heterogeneity, indicating that benefits may vary considerably across settings. These findings support selective whole-blood transfusion protocol implementation in civilian centers while highlighting the need for refined patient selection criteria. | Trauma | https://jamanetwork.com/journals/jamasurgery/fullarticle/2846485?guestAccessKey=53214158-0a23-4439-927a-708def01a130&utm_source=fbpage&utm_medium=social_jamasurg&utm_term=19925110264&utm_campaign=article_alert&linkId=921884838 | Ibrahim W, Meza Monge K, Menzel J, et al. Whole-Blood vs Component Therapy in Adult Trauma: An Updated Systematic Review and Meta-Analysis. JAMA Surg. 2026;161(5):497–506. doi:10.1001/jamasurg.2026.0197 |
| 85 | | | | Prehospital Whole Blood in Traumatic
Hemorrhage — a Randomized Controlled Trial (SWIFT) |
| NEJM | 03/17/26 | Among participants with life-threatening hemorrhage, prehospital transfusion of 2 units of whole blood was not superior to standard care in reducing the risk of death or massive transfusion within 24 hours. (Funded by NHS Blood and Transplant and others; ISRCTN Registry number, ISRCTN23657907.) | PrehospitalTrauma | https://www.nejm.org/doi/full/10.1056/NEJMoa2516043 | Smith JE, Barnard EBG, Brown-O'Sullivan C, Cardigan R, Davies J, Hawton A, Laing E, Lucas J, Lyon R, Perkins GD, Smith L, Stanworth SJ, Weaver A, Woolley T, Green L. The SWiFT trial (Study of Whole Blood in Frontline Trauma)-the clinical and cost effectiveness of pre-hospital whole blood versus standard care in patients with life-threatening traumatic haemorrhage: study protocol for a multi-centre randomised controlled trial. Trials. 2023 Nov 14;24(1):725. doi: 10.1186/s13063-023-07711-4. PMID: 37964393; PMCID: PMC10644622. |
| 86 | | | | Is There a Role for Prehospital Precision Resuscitation? A Prospective Multi-Institutional Blood Analysis |
| Journal of the American College of Surgeons | 04/01/26 | Although pRBCs were not inferior to WB overall, prehospital WB was associated with improved survival in blunt trauma patients and reduced subsequent in-hospital transfusion requirements, supporting injury-specific precision resuscitation strategies. | CostPrehospitalTrauma | https://journals.lww.com/journalacs/abstract/2026/04000/is_there_a_role_for_prehospital_precision.8.aspx | Caputo, Sydney MD; Piehl, Mark MD; Broome, Jacob MD; Holleman, Gerrit BS; Taylor, Caroline BS; Dransfield, Thomas NRP; Tatum, Danielle PhD; Smith, Alison MD, PhD; Marino, Meg MD; Rayburn, David MD; Azar, Faris MD, FACS; Gomez, Mario DO, FACS; Rodriguez Mederos, Dalier MD, MSN-RN, APRN, CCRP; Gibson, Kyle MSN, APRN, AGACNP-BC, TCRN; Krause, Morgan; Hamilton, David MD; Jacome, Tomas MD; Davis, Greg MD; Branney, Scott MD; Harwood, Laura RN; Dorlac, Warren MD; Baxter, Bridget; Puente, Ivan MD; Duchesne, Juan MD, FACS, FCCM, FCCP. Is There a Role for Prehospital Precision Resuscitation? A Prospective Multi-Institutional Blood Analysis. Journal of the American College of Surgeons 242(4):p 785-793, April 2026. | DOI: 10.1097/XCS.0000000000001780 |
| 87 | | | | Emergent Transfusion and Hemolytic Disease of the Fetus and Newborn Risk Mitigation in Females of Childbearing Potential with Life-Threatening Bleeding: A Clinical Practice Guideline |
| Journal of the American College of Surgeons | 05/01/26 | These recommendations provide guidance for the optimal resuscitation and postresuscitation care of FCP with life-threatening bleeding. | Females/OBRh/ABO incompatibility | https://pubmed.ncbi.nlm.nih.gov/41400561/ | Leeper, C. M., Andrews, J. C., Spinella, P. C., Malone, J. R., Polk, T., Robinson, K. A., Sherwood, M., Wilson, L. M., Josephson, C. D., Yazer, M., & Emergent Transfusion and Hemolytic Risk Workgroup (2026). Emergent Transfusion and Hemolytic Disease of the Fetus and Newborn Risk Mitigation in Females of Childbearing Potential with Life-Threatening Bleeding: A Clinical Practice Guideline. Journal of the American College of Surgeons, 242(5), 1406–1416. https://doi.org/10.1097/XCS.0000000000001732 |
| 88 | | | | Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage (TOWAR) |
| NEJM | 05/18/26 | In injured patients with hemorrhagic shock, the use of whole blood for prehospital transfusion did not result in lower 30-day mortality than the use of blood components. (Funded by the Defense Health Agency Research Technology Portfolio Management, Combat Casualty Portfolio; TOWAR ClinicalTrials.gov number, NCT04684719.) | PrehospitalTrauma | https://www.nejm.org/doi/full/10.1056/NEJMoa2602167 | Sperry, J. L., Guyette, F. X., Cotton, B. A., Luther, J. F., Utarnachitt, R. B., Kutcher, M. E., Daley, B. J., Peetz, A. B., Patel, M. B., Goodman, M. D., Claridge, J. A., Patel, N., Harbrecht, B. G., Hashmi, Z. G., Zarychanski, R., Neal, M. D., Yazer, M. H., Martin-Gill, C., Vincent, L. E., Harner, A. M., … TOWAR Study Group (2026). Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage. The New England journal of medicine, 394(23), 2317–2328. https://doi.org/10.1056/NEJMoa2602167 |
| 89 | | | | Next generation spray-dried on-demand plasma: A multicenter, randomized, dose-escalation, first-in-human safety study |
| Transfusion | 05/21/26 | Spray-dried plasma demonstrated a safety profile comparable to standard frozen plasma, with no thromboembolic events observed. Its durable plastic packaging and rapid reconstitution support its potential for widespread use in out-of-hospital care, including emergency and austere environments. | PrehospitalTrauma | https://www.nejm.org/doi/full/10.1056/NEJMoa2516043 | Cancelas JA, Buckley L, Leitman SF, Nestheide S, Gingras L, Munoz D, et al. Next generation spray-dried on-demand plasma: A multicenter, randomized, dose-escalation, first-in-human safety study. Transfusion. 2026. https://doi.org/10.1111/trf.70262 |
| 90 | | | NA | 06/01/28 | Ongoing | Trauma | | |