Early whole blood transfusion boosts survival in trauma patients

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Significant bleeding from traumatic injuries is the number one cause of preventable death in the United States, with most deaths occurring within six hours. Emerging evidence suggests that whole blood transfusion (blood that is not separated into parts) is associated with a survival benefit compared to the traditional use of blood component transfusions (red blood cells, plasma, and platelets) in these patients.

A new study by researchers at the Boston University Chobanian and Avedisian School of Medicine shows that the earlier a person receives a whole blood transfusion for severe traumatic bleeding, the more likely they are to survive. However, if this transfusion is delayed as much as 14 minutes after arrival at the hospital, the survival benefit is significantly reduced.

These findings may lead clinicians and hospital systems to consider whole blood as a standard emergency transfusion product included in larger transfusion protocols. “There may be similar benefits for using whole blood transfusions at the site of injury or during transport.”


Crisanto Torres, MD, MPH, corresponding author, assistant professor of surgery, Boston University Chobanian and Avedisian School of Medicine

Researchers analyzed 1,394 patients nationwide who presented to emergency departments for severe traumatic hemorrhage, requiring massive transfusions including whole blood due to traumatic injuries. They evaluated whether receipt of early whole blood transfusion was associated with improved survival at 24 hours and 30 days versus delayed whole blood transfusion in patients with acute hemorrhagic trauma with component-based therapy. compared to circulation. Patients who received an earlier whole blood transfusion after arriving at the emergency department had an improved survival rate.

“Our study indicates a time goal for whole blood transfusion within 14 minutes of hospital arrival. Survival decreased for every minute delay in whole blood transfusion, but survival was most pronounced after 14 minutes. ,” added Torres, who is also a trauma surgeon at Boston Medical Center.

These results are displayed online JAMA Surgery.

Source:

Journal Reference:

Torres, CM, etc (2024). Time to first complete blood transfusion and survival after severe hemorrhage in trauma patients. JAMA Surgery. doi.org/10.1001/jamasurg.2023.7178.



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