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Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused combat trauma patients (CME)
Article first published online: 26 AUG 2010
© 2010 American Association of Blood Banks
Volume 51, Issue 2, pages 242–252, February 2011
How to Cite
Perkins, J. G., Cap, A. P., Spinella, P. C., Shorr, A. F., Beekley, A. C., Grathwohl, K. W., Rentas, F. J., Wade, C. E., Holcomb, J. B. and the 31st Combat Support Hospital Research Group (2011), Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused combat trauma patients (CME). Transfusion, 51: 242–252. doi: 10.1111/j.1537-2995.2010.02818.x
- Issue published online: 10 FEB 2011
- Article first published online: 26 AUG 2010
- Received for publication February 19, 2010; revision received June 9, 2010, and accepted June 9, 2010.
BACKGROUND: At major combat hospitals, the military is able to provide blood products to include apheresis platelets (aPLT), but also has extensive experience using fresh whole blood (FWB). In massively transfused trauma patients, we compared outcomes of patients receiving FWB to those receiving aPLT.
STUDY DESIGN AND METHODS: This study was a retrospective review of casualties at the military hospital in Baghdad, Iraq, between January 2004 and December 2006. Patients requiring massive transfusion (≥10 units in 24 hr) were divided into two groups: those receiving FWB (n = 85) or aPLT (n = 284) during their resuscitation. Admission characteristics, resuscitation, and survival were compared between groups. Multivariate regression analyses were performed comparing survival of patients at 24 hours and at 30 days. Secondary outcomes including adverse events and causes of death were analyzed.
RESULTS: Unadjusted survival between groups receiving aPLT and FWB was similar at 24 hours (84% vs. 81%, respectively; p = 0.52) and at 30 days (60% versus 57%, respectively; p = 0.72). Multivariate regression failed to identify differences in survival between patients receiving PLT transfusions either as FWB or as aPLT at 24 hours or at 30 days.
CONCLUSIONS: Survival for massively transfused trauma patients receiving FWB appears to be similar to patients resuscitated with aPLT. Prospective trials will be necessary before consideration of FWB in the routine management of civilian trauma. However, in austere environments where standard blood products are unavailable, FWB is a feasible alternative.