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PedsCrit
From the Battlefield to the Bedside: The Past, Present, and Future of Blood Product Resuscitation with Dr. Phil Spinella -- Part 2
Feb 24, 2025
Dr. Philip C. Spinella, a leading professor and trauma expert at the University of Pittsburgh, discusses groundbreaking advancements in blood product resuscitation. He highlights the shift to whole blood use over crystalloids for better survival rates in hemorrhagic shock. The episode delves into the complexities of citrate management in transfusions and the evolution of platelet storage practices. Spinella also explores the importance of localized approaches in pediatric care, concluding with an unexpected culinary diversion featuring a delicious meatball recipe.
42:31
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Quick takeaways
- The shift towards whole blood transfusion in trauma care demonstrates a significant evolution in addressing life-threatening hemorrhages effectively.
- Research into fresh frozen plasma as a volume expander illustrates the ongoing efforts to enhance resuscitation strategies in critical care.
Deep dives
Transition to Hemostatic Resuscitation
The evolution of transfusion practices has seen a significant shift towards hemostatic resuscitation, which emphasizes the use of blood-based fluids instead of crystalloids for patients experiencing life-threatening hemorrhage. In the past, transfusion protocols began with crystalloids, leading to high mortality rates in cases of significant bleeding. Historical data from military practices in places like Baghdad exposed the inefficiencies of this approach, prompting the adoption of whole blood in trauma centers as a more effective method. Current statistics demonstrate that around 350 to 400 trauma centers in the U.S. are now incorporating whole blood into their standard clinical practice, indicating a crucial change in managing critical bleeding situations.
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