Lack of effect of unrefrigerated young whole blood transfusion on patient outcomes after massive transfusion in a civilian setting
- 22 December 2010
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 51 (8), 1669-1675
- https://doi.org/10.1111/j.1537-2995.2010.02975.x
Abstract
Warm fresh whole blood has been advocated for critical bleeding in the military setting. This study assessed whether unrefrigerated young whole blood transfusion, from donation to transfusion less than 24 hours, could reduce mortality of patients with critical bleeding in a civilian setting. A linked data cohort study was conducted on a total of 353 consecutive patients requiring massive transfusion, defined as 10 units or more of red blood cells or whole blood transfusion within 24 hours, in a quaternary health care center in Australia. Of the 353 patients with massive blood transfusion in the study, 77 received unrefrigerated young whole blood transfusion (mean, 4.0 units; interquartile range, 2-6). The diagnosis, severity of acute illness, age, sex, and ABO blood group were not significantly different between the patients who received unrefrigerated young whole blood and those who did not. Unrefrigerated young whole blood transfusions were associated with a slightly improved coagulation profile (lowest fibrinogen concentrations 1.7g/L vs. 1.4g/L, p=0.006; worst international normalization ratio, 2.4 vs. 2.8, p=0.05) but did not reduce the total utilization of allogeneic blood products and subsequent use of recombinant Factor VIIa (27% vs. 22%, p=0.358). Thirty-day mortality and 8-year survival after hospital discharge (hazard ratio, 1.05; 95% confidence interval, 0.41-2.65; p=0.93) were also not different after the use of unrefrigerated young whole blood transfusion. Unrefrigerated young whole blood transfusion was not associated with a reduced mortality of patients requiring massive transfusion in a civilian setting when other blood products were readily available.This publication has 21 references indexed in Scilit:
- The red blood cell storage lesion: a method to the madnessTransfusion, 2010
- New developments in massive transfusion in traumaCurrent Opinion in Anaesthesiology, 2010
- Leukocyte depletion for safe blood transfusionBiotechnology Journal, 2009
- Warm Fresh Whole Blood Is Independently Associated With Improved Survival for Patients With Combat-Related Traumatic InjuriesThe Journal of Trauma and Acute Care Surgery, 2009
- Reconstituted fresh whole blood improves clinical outcomes compared with stored component blood therapy for neonates undergoing cardiopulmonary bypass for cardiac surgery: A randomized controlled trialThe Journal of Thoracic and Cardiovascular Surgery, 2008
- Increased Plasma and Platelet to Red Blood Cell Ratios Improves Outcome in 466 Massively Transfused Civilian Trauma PatientsAnnals of Surgery, 2008
- Fresh blood for everyone? Balancing availability and quality of stored RBCsTransfusion Medicine, 2008
- Clinical consequences of red cell storage in the critically illTransfusion, 2006
- Fresh Whole Blood Transfusion: A Controversial Military PracticeThe Journal of Trauma and Acute Care Surgery, 2006
- The Use of Fresh Whole Blood in Massive TransfusionThe Journal of Trauma and Acute Care Surgery, 2006