Journal Review in Trauma Surgery: Whole Blood Resuscitation in Trauma

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 3 March 2025

⏱️ 29 minutes

🔗️ Recording | iTunes | RSS

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Summary

Do you find yourself saying: “Hey, what’s the big idea with that newfangled whole blood in the refrigerator next to the trauma bay?” Like using whole blood but not sure why? Don’t like using whole blood but not sure why? Join us for a 30 minute power session in whole blood where we try to get you the information you need to know!

Hosts:
- Michael Cobler-Lichter, MD, PGY4/R2:
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@mdcobler (X/twitter)

- Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow
University of Pennsylvania
Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency
@urrechisme (X/twitter)

- Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending:
Loma Linda University
Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship

- Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 6 years in practice
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@jpmeizoso (twitter)

Learning Objectives:
- Describe the proposed benefits of whole blood resuscitation in trauma

- Identify current problems with synthesizing the existing literature on whole blood resuscitation in trauma

- Propose needed areas for future research regarding whole blood resuscitation in trauma

Quick Hits:
1. There is significant heterogeneity in study design across whole blood resuscitation studies, complicating comparison

2. There is likely a mortality benefit to whole blood resuscitation in trauma, however this is likely dependent on the specific population

3. Future research directions should focus on prospective randomized work to try and better quantify the exact benefit of whole blood, and determine in which populations this benefit is actually realized

References

1. Hazelton JP, Ssentongo AE, Oh JS, Ssentongo P, Seamon MJ, Byrne JP, Armento IG, Jenkins DH, Braverman MA, Mentzer C, Leonard GC, Perea LL, Docherty CK, Dunn JA, Smoot B, Martin MJ, Badiee J, Luis AJ, Murray JL, Noorbakhsh MR, Babowice JE, Mains C, Madayag RM, Kaafarani HMA, Mokhtari AK, Moore SA, Madden K, Tanner A 2nd, Redmond D, Millia DJ, Brandolino A, Nguyen U, Chinchilli V, Armen SB, Porter JM. Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding: A Multicenter Study. Ann Surg. 2022 Oct 1;276(4):579-588. doi: 10.1097/SLA.0000000000005603. Epub 2022 Jul 18. PMID: 35848743.
https://pubmed.ncbi.nlm.nih.gov/35848743/

2. Sperry JL, Cotton BA, Luther JF, Cannon JW, Schreiber MA, Moore EE, Namias N, Minei JP, Wisniewski SR, Guyette FX; Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group. Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality. J Am Coll Surg. 2023 Aug 1;237(2):206-219. doi: 10.1097/XCS.0000000000000708. Epub 2023 Apr 11. PMID: 37039365; PMCID: PMC10344433.
https://pubmed.ncbi.nlm.nih.gov/37039365/

3. Meizoso JP, Cotton BA, Lawless RA, et al. Whole blood resuscitation for injured patients requiring transfusion: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2024;97(3):460-470. doi:10.1097/TA.0000000000004327
https://pubmed.ncbi.nlm.nih.gov/38531812/

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Transcript

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0:00.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to't just about the OR.
0:26.4	It's about shaping your future.
0:28.4	Start tracking every step of your career with UNERA, the app revolutionizing how surgeons manage their information.
0:35.2	Log your surgical cases, document your M&Ms, track your papers,
0:38.6	presentations, and abstracts all in one place. Learn about productivity and RVUs to prepare you
0:44.3	for when it's time to negotiate your contract. In the best part, you own your data, your portfolio,
0:50.6	your future. Unera, your career, your data, your journey. Download now and start owning your future.
0:58.4	Hey, everyone. Welcome to another episode of Behind the Knife's Journal review series. We are the
1:02.8	Miami Trauma Dean back with another episode from Jackson Memorial Hospital's writer trauma center.
1:07.5	In this episode, we're going to be talking about the use of whole blood in the
1:10.8	resuscitation of trauma patients. This is something that's really seen a resurgence in the last
1:15.3	five to ten years or so, and there's a lot of different data out there. So we're going to try and
1:19.6	get you the information you need to know. It's funny how we so often see the pendulum swing back and
1:24.9	forth over the years in medicine. All of us in trauma have
1:27.8	seen the evolution of blood product resuscitation over the last several decades. And while the use
1:32.8	of whole blood was common during early global conflicts, the discovery of blood fractionation techniques,
1:38.2	which allow blood bankers to deconstruct whole blood into its individual components, resulted in a
1:43.6	shift to the component-paced
1:44.8	transfusion strategy for the latter part of the 20th century. And so the fractionated blood is just
1:49.6	what we had and used for a while. Now, there's been a resurgent interest in the use of whole blood
1:55.1	for trauma resuscitation as a result of promising data from recent world conflicts in Iraq and
2:00.0	Afghanistan. But how do we
	...

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