Journal Review in Trauma Surgery: Blood Transfusions

22 snips

Feb 9, 2023

Exploration of the history of blood transfusions, the survival advantage of whole blood transfusions in trauma patients, and the incorporation of whole blood transfusion in standard medical procedures. Advanced techniques like Rotem and Teg for guiding resuscitation, importance of blood products in trauma care, and comparison of use in military and civilian settings.

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INSIGHT

Key Milestones in Blood Transfusion History

The discovery of blood groups by Karl Landsteiner enabled safe blood transfusions and revolutionized trauma care.
Advances like blood fractionation and plastic bags for collection facilitated the transition to component therapy.

INSIGHT

Military Insights Revive Whole Blood Use

Military use of fresh whole blood has demonstrated clear survival benefits for trauma hemorrhage patients.
This has sparked renewed interest in whole blood transfusion in civilian trauma care, though it's not yet standard.

INSIGHT

Whole Blood Enhances Survival Benefits

Whole blood transfusion combined with massive transfusion protocols improves survival at 24 hours and 30 days without increasing complications.
This retrospective study supports whole blood's survival benefit in severe hemorrhage trauma patients.

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In this episode, our team discusses the recent paper from JAMA Surgery Association of Whole Blood With Survival Among Patients Presenting With Severe Hemorrhage in US and Canadian Adult Civilian Trauma Centers. Join us as we explore some of the history of blood transfusions, how we got to where we are today, and the role whole blood transfusion may play going forward

Hosts:
Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST) and editor-in-chief of Trauma Surgery and Acute Care Open.

Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins.

David Sigmon, MD, MMEd, a PGY-7 resident at the University of Illinois at Chicago who will be a fellow at Lincoln Medical Center in the Bronx next year. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education.

LITERATURE

Torres CM, Kent A, Scantling D, Joseph B, Haut ER, Sakran JV. Association of whole blood with survival among patients presenting with severe hemorrhage in US and Canadian adult civilian trauma centers. JAMA Surg. Published online January 18, 2023.
https://pubmed.ncbi.nlm.nih.gov/36652255/
Sperry JL, Guyette FX, Brown JB, et al. Prehospital plasma during air medical transport in trauma patients at risk for hemorrhagic shock. N Engl J Med. 2018;379(4):315-326.
https://pubmed.ncbi.nlm.nih.gov/30044935/
Moore HB, Moore EE, Chapman MP, et al. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018;392(10144):283-291.
https://pubmed.ncbi.nlm.nih.gov/30032977/
Cannon JW, Khan MA, Raja AS, et al. Damage control resuscitation in patients with severe traumatic hemorrhage: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):605-617.
https://pubmed.ncbi.nlm.nih.gov/28225743/
Howley IW, Haut ER, Jacobs L, Morrison JJ, Scalea TM. Is thromboelastography (Teg)-based resuscitation better than empirical 1:1 transfusion? Trauma Surg Acute Care Open. 2018;3(1):e000140.
https://pubmed.ncbi.nlm.nih.gov/29766129/
Guyette FX, Brown JB, Zenati MS, et al. Tranexamic acid during prehospital transport in patients at risk for hemorrhage after injury: a double-blind, placebo-controlled, randomized clinical trial. JAMA Surg. 2020;156(1):11-20.
https://pubmed.ncbi.nlm.nih.gov/33016996/
Smart BJ, Haring RS, Zogg CK, et al. A faculty-student mentoring program to enhance collaboration in public health research in surgery. JAMA Surg. 2017;152(3):306-308.
https://pubmed.ncbi.nlm.nih.gov/27973649/
National Academies of Sciences E. A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths after Injury.; 2016.
https://nap.nationalacademies.org/catalog/23511/a-national-trauma-care-system-integrating-military-and-civilian-trauma
Braverman MA, Smith A, Pokorny D, et al. Prehospital whole blood reduces early mortality in patients with hemorrhagic shock. Transfusion. 2021;61 Suppl 1:S15-S21.
https://pubmed.ncbi.nlm.nih.gov/34269467/

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