Hey folks, Scott Weingard here, and this is the M-Crip podcast. Today on the podcast, an update on

massive transfusion and hemostatic resuscitation. Nine years ago, I had Dr. John Holcomb on to discuss

his proper trial. Can't believe it's been that long. Since then, there has been a bunch of randomized

controlled trials in the massive transfusion space.

And I wanted to bring them back on to get an update and figure out where we are right now and what we should be doing.

So that's what we did. And it was a fantastic episode. I think you're going to love it.

So let's just dive right in. Dr. Holcomb, welcome back. The last time we had you on the show was to

discuss your proper trial. And we've had a lot changed since then. We've had a lot of new studies.

In fact, I've been surprised that we've had so many beautiful randomized controlled trial just

in the past year or two. So I wanted to get your opinion on where we stand on massive transfusion.

Yeah, Scott, thanks for your you to be back and speak again.

I think we're at a tipping point in blood transfusion

for patients, all patients in hemorrhagic shock.

I'm a trauma certain military and civilian,

and so spent a lot of time with people that are injured.

But there's a lot of folks in hemorrhagic shock who

aren't injured, GI bleeding, postpartum hemorrhage, maternal fetal bleeding, ectopics, etc.

And what's happened from the trauma world that's spilled over those other places, both

pretty hospital, which I know we're probably going to talk about, and in the hospital.

Absolutely. And one of the biggest changes I've noted,

a C change in R transfusion, is low-tider, oh, whole blood. And I wanted to ask you a few questions about that.

We have a study now showing some mortality benefit. We have systematic reviews and meta-analys

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