Inova Health System McLean, Virginia, United States
Background/Case Studies: Hemorrhagic shock is a major cause of early trauma death. Prompt, balanced resuscitation is critical, particularly during massive transfusion protocol (MTP) activation, where each minute of delay raises mortality by 5%. Traditional component therapy administering red cells, plasma, and platelets separately can result in delays and imbalanced resuscitation. A remotely located hospital-based blood center plays a vital role by ensuring timely blood product access. With integrated capabilities for collection, processing, testing, and distribution, the center supports trauma care and MTPs through streamlined logistics and coordinated delivery of products like low-titer group O whole blood (LTOWB). LTOWB offers a physiological 1:1:1 ratio of red cells, plasma, and platelets in one unit, enabling faster and effective resuscitation. Cold-stored whole blood also preserves platelet hemostatic function similar to room temperature platelets. Studies show LTOWB contributes to survival benefits, cost savings, and decrease in length of hospital stay. In addition, LTOWB usage increases the availability of other blood components for patients in need. Unused LTOWB units can be converted to packed red blood cells, improving resource efficiency.
Study
Design/Methods: This study will employ a retrospective cohort design to assess the effects of LTOWB using anti-A/anti-B isoagglutinin titer of 1:128 and blood component therapy in trauma and non-trauma patients. Data was obtained from 650 patients who were transfused 1270 units of LTOWB from 2020-2024. In addition, trend in usage of LTOWB versus component therapy was reviewed.
Results/Findings: The findings of this study indicate that whole blood resuscitation is associated with decreased blood component transfusion requirements by approximately 50%. Utilizing LTOWB resulted in significant cost savings, with reductions exceeding 50% in applicable cases. The use of LTOWB for resuscitation from 2020 to 2024 was associated with reduced blood component utilization. Additionally, its use in emergency settings lowers the risk of multiple donor exposure compared to transfusing multiple blood components.
Conclusions: Conclusion:
Hemorrhagic shock is a major cause of early mortality in trauma and non-trauma patients, and timely, balanced resuscitation is essential for survival. The use of LTOWB in a provides an efficient, balanced solution for trauma resuscitation, offering a 1:1:1 ratio of red cells, plasma, and platelets in a single unit. Clinical evidence shows LTOWB reduces transfusion requirements of blood components, and complications, while improving cost savings and operational efficiency. This approach enhances patient outcomes and resource utilization, contributing to better survival rates in critically injured patients. Additional studies merit more clinical information about the benefits of LTOWB.
