Whole blood, fixed ratio, or goal-directed blood component therapy for the initial resuscitation of severely hemorrhaging trauma patients: A narrative review

Mark Walsh, Ernest Moore, Hunter Moore, Scott Thomas, Hau C. Kwaan, Jacob Speybroeck, Mathew Marsee, Connor M. Bunch, John Stillson, Anthony V. Thomas, Annie Grisoli, John Aversa, Daniel Fulkerson, Stefani Vande Lune, Lucas Sjeklocha, Quincy K. Tran*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

This narrative review explores the pathophysiology, geographic variation, and historical de-velopments underlying the selection of fixed ratio versus whole blood resuscitation for hemorrhaging trauma patients. We also detail a physiologically driven and goal-directed alternative to fixed ratio and whole blood, whereby viscoelastic testing guides the administration of blood components and factor concentrates to the severely bleeding trauma patient. The major studies of each resuscitation method are highlighted, and upcoming comparative trials are detailed.

Original languageEnglish (US)
Article number320
Pages (from-to)1-17
Number of pages17
JournalJournal of Clinical Medicine
Volume10
Issue number2
DOIs
StatePublished - Jan 2 2021

Keywords

  • Blood component transfusion
  • Blood transfusion
  • Exsanguination
  • Fibrinogen
  • Hemostat-ics
  • Thromboelastography

ASJC Scopus subject areas

  • Medicine(all)

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