American Surgical Association Home American Surgical Association Annual Meeting
Search Meeting Site Only
Annual Meeting Home
Program
Past & Future Meetings

 

 

Back to Annual Meeting Abstracts


A Randomized Controlled Trial of Modified Whole Blood Versus Component Therapy in Severely Injured Patients Requiring Transfusions
Bryan A Cotton*, Jeannette Podbielski*, Elizabeth Camp*, Timothy Welch*, Deb del Junco*, Rosemary A Kozar, Yu Bai*, Rhonda Hobbs*, Charles E Wade*, Brijesh S Gill*, Michelle K McNutt*, George H Tyson*, Laura Moore*, Rondel Albarado*, John B Holcomb
University of Texas Health Science Center-Houston, Houston, TX

OBJECTIVE(S):
Following advances in Blood Banking in 1970’s, blood donor centers began supplying hospitals with individual components (RBC, plasma, platelets) and removed WB as an available product. However, no studies of efficacy or hemostatic potential were performed in trauma patients prior to doing so. The objective was to determine if resuscitation of severely injured patients with WB results in fewer overall transfusions compared with component therapy
METHODS:
Single center, randomized trial of severely injured patients predicted to receive massive transfusion. Patients were randomized to WB (1 U WB + 1 U platelets) or component, COMP, (1 U RBC+ 1U plasma+ 1U platelets) immediately on arrival. 1U WB= 1U RBC+ 1U plasma. Primary outcome was 24-hour transfusion volumes.
RESULTS:
107 patients were randomized (55 WB, 52 COMP) over 14-months. There were no differences in demographics, arrival vital signs or laboratory values, injury severity or mechanism. Overall, transfusion volumes were similar between groups. However, when excluding severe brain injury patients, WB group received less 24-hour RBC (median 3 vs. 6, p=0.02), plasma (4 vs. 6, p=0.02), platelets (0 vs. 3, p=0.09) and total products (11 vs. 16, p=0.02). Linear regression confirmed these findings (p<0.05).
CONCLUSIONS:
Compared to component therapy, WB did not reduce transfusion volumes in severely injured inured predicted to receive massive transfusion. However, in patients without severe brain injuries, modified WB significantly reduced transfusion volumes.


Back to Annual Meeting Abstracts

 



© 2019 American Surgical Association. All Rights Reserved. Privacy Policy.