ABSTRACT
INTRODUCTION
Resuscitation of severely injured trauma patients is commonly performed using red
blood cells in additive solution supplemented with plasma and platelet concentrates.
There is an increasing interest in the use of low anti-A titer Group O whole blood
(LTOWB) in the early management of the resuscitation. It is unclear whether clinical
outcome is improved using this approach.
METHODS
Expired units of CPD-LTOWB were studied on Day 22 and expired units of thawed plasma
on Day 6 and Day 7. LTOWB was assessed for hemoglobin content, clotting factor levels
and platelet numbers and function using thromboelastography ( TEG) and impedance aggregation.
Assays of fibrinogen and FV, FVIII, FVII and FX were performed on the expired plasma.
The LTOWB hemoglobin was compared to red cells in additive solution (AS-RBCs) and
the clotting factor levels to those of expired thawed plasma. Platelet function was
compared to fresh whole blood samples from healthy subjects.
RESULTS
LTOWB contained slightly more hemoglobin than the AS-RBCs (Medians, 66 v 59 G), and the plasma content of fibrinogen was similar. Other clotting factors were
reduced by approximately 15% except for FVIII which was 30% less. Both TEG and impedance
aggregometry showed evidence of residual platelet function despite the prolonged period
of refrigerator storage.
CONCLUSION
LTOWB contains higher hemoglobin and adequate clotting factors, and residual platelet
function is demonstrated indicating that this product would be expected to be at least
equivalent to a single unit of each of the conventional components commonly used in
trauma resuscitation.
Keywords
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Article info
Publication history
Accepted:
August 23,
2022
Received in revised form:
August 4,
2022
Received:
May 27,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
