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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Leeper CM, Yazer MH, Neal MD. Whole-Blood Resuscitation of Injured Patients: Innovating from the Past. JAMA Surg. Published online May 13, 2020. doi:10.1001/jamasurg.2020.0811
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