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Surgical Innovation
May 13, 2020

Whole-Blood Resuscitation of Injured Patients: Innovating from the Past

Author Affiliations
  • 1Pittsburgh Trauma Research Center, University of Pittsburgh Medical Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2University of Pittsburgh Medical Center, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Surg. Published online May 13, 2020. doi:10.1001/jamasurg.2020.0811

Whole-blood (WB) transfusion for the treatment of hemorrhagic shock and coagulopathy after injury has a long history in military medicine. Within the last century, whole blood was replaced in civilian trauma by component products and an overreliance on crystalloid resuscitation. The era of hemostatic resuscitation emphasizes a balanced transfusion strategy, with ratios of plasma and platelets to packed red blood cells (RBC) that attempt to mimic or reconstitute the composition of whole blood. Within the past decade, the pendulum has swung back to WB, although in an innovative and modified form: cold-stored low-titer anti-A and anti-B group O whole blood (LTOWB).

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