Modified Whole Blood vs. Component Therapy in Severely Injured Patients

March 17, 2014 - Hemorrhage remains a leading cause of early death in both civilian trauma and military combat casualty care. The transfusion of whole blood for trauma induced coagulopathy is not routinely done in civilian practice, but US military physicians have used fresh whole blood in every combat operation since the practice was introduced in World War I. So which is superior, whole blood or component therapy, or are they the same? CeTIR investigators, led by Dr. Bryan Cotton, conducted a randomized controlled pilot trial to begin to answer this question. A total of 107 patients were randomized over a 14 month period. With no differences in baseline demographics or injury severity, 55 patients were randomized into the whole blood group and 52 were randomized to component therapy. Compared to component therapy, whole blood did not reduce transfusion volume requirements in these injured patients and there were no differences in 24-hour and 30-day mortality between the two groups. However, the use of whole blood significantly reduced transfusion volumes in patients without severe brain injuries. The study results were published in the October issue of Annals of Surgery. Read More