Cold-stored Whole Blood: A Better Method of Trauma Resuscitation?

Abstract

In the setting of trauma with hemorrhagic shock, balanced blood product resuscitation requires transfusing a high ratio of plasma and platelets to red blood cells. Multiple units of blood products must be transfused rapidly, each product is separately packaged, and each product has a different volume, preparation method, shelf-life, and availability. Despite limited initial data comparing whole blood (WB) to blood component therapy (BCT), recent military medicine shows both a survival benefit and safety of warm WB transfusion over component therapy. This has sparked a renewed interest in the practice of using cold-stored type-O WB (CWB) for resuscitation of hemorrhagic shock in the civilian setting. While recent studies have demonstrated benefits and safety when comparing type-specific and type-O CWB verses component therapy, they have not evaluated the acute resuscitative period. The purpose of this study was to report the impact of CWB on initial resuscitation.