US Central Command Military Blood Use Practices 2011−2020

Abstract

Introduction: Military involvement in Afghanistan ended in 2021 and while low intensity troop engagements continue globally, casualty numbers are dwindling. To understand the clinical and operational connections between blood use and clinical paradigm shifts in resuscitation strategies, a review of blood product use and the changes in the last decade was conducted within the US Central Command area of responsibility (AOR). The intent of this review was to assess patterns of blood use during the last decade of the US’s involvement in the most recent major conflicts in order to potentially inform future blood requirements. Methods: Blood product and types transfused between Jan 1, 2011 and Dec 31, 2020 were acquired from the Medical Situational Awareness in Theater (MSAT) blood reports. All reported blood usage data in the US Central Command area of responsibility were queried. Results: Packed red blood cells and fresh frozen plasma usage showed no statistically significant change over time (τb=0.24, p = 0.3252; τb=-0.47, p = .0603). Fresh and stored whole blood use increased overtime (τb=0.69, p = 0.0056; τb=0.83, p = 0.0015). A strong inverse relationship was found between SWB and FFP usage (r= -0.68, p = .0309) and LP and FFP usage (r= -0.65, p = 0.0407) over time. Conclusion: Whole blood usage increased significantly over time with a preference for stored whole blood. Component therapy is anticipated to remain a critical element of resuscitation in the event of large-scale combat operations secondary to supply chain and longer storage times.