Initial Safety and Feasibility of Cold Stored Uncrossmatched Whole Blood Transfusion in Civilian Trauma Patients.

Background: The transfusion of cold stored uncrossmatched whole blood (WB) has not been extensively utilized in civilian trauma resuscitation. This report details the initial experience with the safety and feasibility of using WB in this setting after a change of practice at a level 1 trauma center was instituted. Methods: Up to two units of uncrossmatched group O positive WB that was leukoreduced using a platelet sparing filter from male donors were transfused to male trauma patients with hypotension secondary to bleeding. Hemolytic marker haptoglobin and reports of transfusion reactions in these patients were followed. Additionally, transfusion volumes and outcomes were compared to a historical cohort of male trauma patients who received at least 1 red blood cell (RBC) unit, but not WB, during the first 24 hours of admission. Results: There were 47 WB patients who were transfused with a mean of 1.74 (+/-0.61) WB units. The median haptoglobin concentration on post-WB transfusion day 1 was 25.1 mg/dl (+/-9.3) in 7/30 non-group O recipients. No adverse reactions in temporal relation to the WB transfusions were reported. There were 145 male historical control patients identified who were resuscitated with component therapy; the median volume of incompatible plasma transfused to the WB vs. component therapy group was not significantly different (1000 ml vs. 800 ml, respectively, p=0.38); the mean plasma:RBC (0.99+/-0.47 vs. 0.77+/-0.73, respectively, p=0.006) and platelet:RBC (0.72+/-0.40 vs. 0.51+/-0.734, respectively, p

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