L’utilisation du sang total dans la prise en charge des hémorragies massives : rationnel clinico-biologique et principes de mise en œuvre

Abstract

AbstractAlthough its use has disappeared from developing countries for years, whole blood (WB) is afresh a therapeutic option in the management of trauma-related massive hemorrhage as far as it provides useful benefits in the execution of the damage control resuscitation strategy. Indeed, this strategy has constraints that are mainly logistic due to the need of a quick availability of plasma and platelets units. As it is a “all-in-one” blood product, O-group WB provides red blood cells, platelets and plasma in a single unit instead of three and ease the transfusion in these situations. These O-group WB transfusion may expose recipients to ABO-incompatible plasma and provides unagitated cold-stored platelets, however a lot of evidences support the safety of this strategy in emergency situations. Beyond, the logistic benefit, use of WB is related to a clinical one which is currently evaluated in several clinical trials.