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A comparison between leukocyte reduced low titer whole blood vs non‐leukocyte reduced low titer whole blood for massive transfusion activation
Author(s) -
Fadeyi Emmanuel A.,
Saha Amit K.,
Naal Tawfeq,
Martin Harrison,
Fenu Elena,
Simmons Julie H.,
Jones Mary Rose,
Pomper Gregory J.
Publication year - 2020
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16066
Subject(s) - medicine , blood transfusion , injury severity score , observational study , resuscitation , titer , whole blood , prospective cohort study , adverse effect , emergency medicine , poison control , immunology , injury prevention , antibody
Background Hemorrhagic shock is the leading cause of survivable death in trauma patients and recent literature has focused on resuscitation strategies including transfusing low‐titer group O whole blood (LTOWB). Debate remains regarding whether leukocyte reduced (LR) whole blood is of clinical benefit or detriment to patients requiring massive transfusion. This study compares survival outcomes between LR‐LTOWB and non‐LR LTOWB. Study Design and Methods The objective of this prospective, observational study was to detect any difference in 24‐hour survival between patients receiving LR‐LTOWB and non‐LR LTOWB during their massive transfusion activation. Secondary objectives were to report any difference in ICU LOS, ventilation days, in‐hospital survival, and hospital LOS. Data collected included patient sex, age, mechanism of injury, Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), cause of death, and number of LTOWB transfused. Results A total of 167 patients received 271 LTOWB transfusions. There were 97 patients that received 168 units of LR‐LTOWB while 70 patients received 103 units of non‐LR LTOWB. The two study groups were comparable in terms of age, sex, ISS, TRISS, and the number of LTOWB transfused. The use of LR LTOWB during the initial massive transfusion activation in traumatically injured patients was not associated with increased 24‐hour survival compared to when using non‐LR LTOWB. No transfusion associated adverse events were reported. Conclusions The administration of either LR or non‐LR LTOWB was not associated with >24 hours survival in patients presenting with massive hemorrhage. The high cost and the rapid decline in platelet count of LR whole blood may be a consideration.