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

doi:10.3390/jcm10020320

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

Medicine, Hematology Oncology Division

Research output: Contribution to journal › Review article › peer-review

14 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 language	English (US)
Article number	320
Pages (from-to)	1-17
Number of pages	17
Journal	Journal of Clinical Medicine
Volume	10
Issue number	2
DOIs	https://doi.org/10.3390/jcm10020320
State	Published - Jan 2 2021

Keywords

Blood component transfusion
Blood transfusion
Exsanguination
Fibrinogen
Hemostat-ics
Thromboelastography

ASJC Scopus subject areas

Medicine(all)

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10.3390/jcm10020320

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Walsh, M., Moore, E., Moore, H., Thomas, S., Kwaan, H. C., Speybroeck, J., Marsee, M., Bunch, C. M., Stillson, J., Thomas, A. V., Grisoli, A., Aversa, J., Fulkerson, D., Lune, S. V., Sjeklocha, L., & Tran, Q. K. (2021). Whole blood, fixed ratio, or goal-directed blood component therapy for the initial resuscitation of severely hemorrhaging trauma patients: A narrative review. Journal of Clinical Medicine, 10(2), 1-17. [320]. https://doi.org/10.3390/jcm10020320

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

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.",

keywords = "Blood component transfusion, Blood transfusion, Exsanguination, Fibrinogen, Hemostat-ics, Thromboelastography",

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

note = "Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = jan,

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doi = "10.3390/jcm10020320",

language = "English (US)",

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Walsh, M, Moore, E, Moore, H, Thomas, S, Kwaan, HC, Speybroeck, J, Marsee, M, Bunch, CM, Stillson, J, Thomas, AV, Grisoli, A, Aversa, J, Fulkerson, D, Lune, SV, Sjeklocha, L & Tran, QK 2021, 'Whole blood, fixed ratio, or goal-directed blood component therapy for the initial resuscitation of severely hemorrhaging trauma patients: A narrative review', Journal of Clinical Medicine, vol. 10, no. 2, 320, pp. 1-17. https://doi.org/10.3390/jcm10020320

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AU - Walsh, Mark

AU - Moore, Ernest

AU - Moore, Hunter

AU - Thomas, Scott

AU - Kwaan, Hau C.

AU - Speybroeck, Jacob

AU - Marsee, Mathew

AU - Bunch, Connor M.

AU - Stillson, John

AU - Thomas, Anthony V.

AU - Grisoli, Annie

AU - Aversa, John

AU - Fulkerson, Daniel

AU - Lune, Stefani Vande

AU - Sjeklocha, Lucas

AU - Tran, Quincy K.

PY - 2021/1/2

Y1 - 2021/1/2

N2 - 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.

AB - 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.

KW - Blood component transfusion

KW - Blood transfusion

KW - Exsanguination

KW - Fibrinogen

KW - Hemostat-ics

KW - Thromboelastography

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

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