Clinical outcomes among low‐titer group O whole blood recipients compared to recipients of conventional components in civilian trauma resuscitation
- 30 August 2018
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 58 (8), 1838-1845
- https://doi.org/10.1111/trf.14779
Abstract
BACKGROUND The serological safety of transfusing ≤4 units of low titer group O whole blood (LTOWB) in civilian trauma patients has been demonstrated. This study investigated clinical outcomes of LTOWB recipients compared to patients who received only conventional blood components during their resuscitation. STUDY DESIGN AND METHODS A retrospective analysis of trauma patients' medical records who received LTOWB during the first 24 hours of their admission was performed. Using a 12‐parameter propensity matching strategy, LTOWB recipients were matched to other patients who received at least one red blood cell (RBC) unit during their first 24 hours of admission but not LTOWB. The primary outcomes were mortality and blood use. RESULTS A total of 135 patients who received LTOWB (median 2 units) were matched to 135 patients who received conventional components. There were no significant differences in the matching parameters between the groups. There were no significant differences in outcomes between the conventional component and LTOWB groups: median (interquartile range) in‐hospital mortality, 24.4% vs. 18.5% (respectively, p = 0.24); 24‐hour mortality, 12.6% vs. 8.9% (respectively, p = 0.33). The hospital and intensive care unit lengths of stay were not significantly different between groups. The median number of RBC units transfused, including the contribution from the LTOWB, was not significantly different between the groups. The time to normalization of elevated plasma lactate levels tended to be shorter among the LTOWB recipients compared to the conventional component recipients (median 8.1 [3.7‐15.4] hr vs. 13.2 [4.4‐26.8] hr, respectively, p = 0.05). CONCLUSION The LTOWB recipients had similar clinical outcomes compared to recipients of conventional component therapy.Keywords
This publication has 20 references indexed in Scilit:
- Raising the standards on whole bloodJournal Of Trauma-Injury Infection and Critical Care, 2018
- Safety profile of uncrossmatched, cold‐stored, low‐titer, group O+ whole blood in civilian trauma patientsTransfusion, 2018
- RePHILL: protocol for a randomised controlled trial of pre‐hospital blood product resuscitation for traumaTransfusion Medicine, 2017
- Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day SurvivalJAMA, 2017
- Every minute countsJournal Of Trauma-Injury Infection and Critical Care, 2017
- Safety of the use of group A plasma in trauma: the STAT studyTransfusion, 2017
- Measurement of haemolysis markers following transfusion of uncrossmatched, low‐titre, group O+ whole blood in civilian trauma patients: initial experience at a level 1 trauma centreTransfusion Medicine, 2016
- Initial safety and feasibility of cold-stored uncrossmatched whole blood transfusion in civilian trauma patientsJournal Of Trauma-Injury Infection and Critical Care, 2016
- Taking the Blood Bank to the Field: The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) TrialPrehospital Emergency Care, 2015
- Anti‐A and anti‐B titers in pooled group O platelets are comparable to apheresis plateletsTransfusion, 2008