Mark H Yazer1, Philip C Spinella2, Vincent Anto3, Nancy M Dunbar4. 1. Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 2. Department of Pediatrics, Division of Critical Care Medicine, Washington University in St Louis, St Louis, Missouri, USA. 3. Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 4. Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Abstract
BACKGROUND: Recently revisited products like low-titer group O whole blood (LTOWB) and novel applications of group A as a universal donor of plasma are being used for trauma resuscitation. A survey of American Level 1 trauma centers was performed to elucidate the extent to which these products are currently employed. METHODS: A survey was written that probed into the current use of blood products in trauma resuscitation with specific emphasis on LTOWB and group A plasma. A list of adult civilian Level 1 trauma centers in the continental USA was obtained from two public surgery and trauma focused websites. An email was then sent to each center's transfusion service medical director or laboratory manager providing them with a link to the online survey. RESULTS: Responses were received from 103/187 (55%) adult civilian Level 1 trauma centers. For the resuscitation of trauma patients, group A plasma was used at 94/103 (91%) centers, while LTOWB was used at 43/103 (42%) centers. There were 39/103 (38%) centers that used both products. At 62/94 (66%) of the centers that used group A plasma, there was no limit on the number of units that could be administered, while an unlimited number of LTOWB units could be used at 5/43 (12%) of the centers that used LTOWB. RhD-positive LTOWB could be transfused to RhD-negative or RhD-type unknown females of childbearing potential at 22/43 (51%) of centers. CONCLUSION: The use of group A plasma and LTOWB in trauma is increasing at American Level 1 trauma centers.
BACKGROUND: Recently revisited products like low-titer group O whole blood (LTOWB) and novel applications of group A as a universal donor of plasma are being used for trauma resuscitation. A survey of American Level 1 trauma centers was performed to elucidate the extent to which these products are currently employed. METHODS: A survey was written that probed into the current use of blood products in trauma resuscitation with specific emphasis on LTOWB and group A plasma. A list of adult civilian Level 1 trauma centers in the continental USA was obtained from two public surgery and trauma focused websites. An email was then sent to each center's transfusion service medical director or laboratory manager providing them with a link to the online survey. RESULTS: Responses were received from 103/187 (55%) adult civilian Level 1 trauma centers. For the resuscitation of traumapatients, group A plasma was used at 94/103 (91%) centers, while LTOWB was used at 43/103 (42%) centers. There were 39/103 (38%) centers that used both products. At 62/94 (66%) of the centers that used group A plasma, there was no limit on the number of units that could be administered, while an unlimited number of LTOWB units could be used at 5/43 (12%) of the centers that used LTOWB. RhD-positive LTOWB could be transfused to RhD-negative or RhD-type unknown females of childbearing potential at 22/43 (51%) of centers. CONCLUSION: The use of group A plasma and LTOWB in trauma is increasing at American Level 1 trauma centers.