Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis
Abstract Background Patients with hemorrhagic shock from trauma often require balanced blood product transfusion with red blood cells, plasma, and platelets. Resuscitation with whole blood resuscitation is becoming a common practice. We performed a systematic review and meta‐analysis of studies comp...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-08-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12089 |
| _version_ | 1828389333304868864 |
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| author | Ellen Crowe Stacia M. DeSantis Austin Bonnette Jan O. Jansen Jose‐Miguel Yamal John B. Holcomb Claudia Pedroza John A. Harvin Marisa B. Marques Elenir B.C. Avritscher Henry E. Wang |
| author_facet | Ellen Crowe Stacia M. DeSantis Austin Bonnette Jan O. Jansen Jose‐Miguel Yamal John B. Holcomb Claudia Pedroza John A. Harvin Marisa B. Marques Elenir B.C. Avritscher Henry E. Wang |
| author_sort | Ellen Crowe |
| collection | DOAJ |
| description | Abstract Background Patients with hemorrhagic shock from trauma often require balanced blood product transfusion with red blood cells, plasma, and platelets. Resuscitation with whole blood resuscitation is becoming a common practice. We performed a systematic review and meta‐analysis of studies comparing whole blood transfusion with balanced component therapy in patients suffering from traumatic hemorrhagic shock. Methods We searched MEDLINE Ovid, EMBASE, and the Cochrane Library for human studies comparing whole blood with component blood therapy published from January 2007 to June 2019. We included studies from both civilian and military settings and that reported 24‐hour, in‐hospital, or 30‐day mortality. We followed the Preferred Reporting Items in Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, assessing study quality, publication bias, and heterogeneity. We used meta‐analytic models to determine the associations (odds ratio [OR] with 95% confidence interval [CI]) between whole blood transfusion and (1) 24‐hour mortality, and (2) in‐hospital or 30‐day mortality. Results A total of 1759 identified studies, 12 (reporting on n = 8431 patients) met inclusion criteria. There was heterogeneity in the design, setting, interventions, and outcomes of the studies. On meta‐analysis, whole blood transfusion was not associated with 24‐hour mortality (OR = 0.83; 95% CI = 0.56–1.24) or in‐hospital/30‐day mortality (OR = 0.79; 95% CI = 0.48–1.31). Conclusion In this systematic review and meta‐analysis, compared with conventional component transfusion, whole blood was not associated with 24‐hour or in‐hospital mortality. However, there were important limitations with and heterogeneity among the primary studies. Additional study is needed to determine the effectiveness of whole blood. |
| first_indexed | 2024-12-10T06:27:33Z |
| format | Article |
| id | doaj.art-f758baf323de4446a3350bfb60b34255 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-12-10T06:27:33Z |
| publishDate | 2020-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-f758baf323de4446a3350bfb60b342552022-12-22T01:59:10ZengWileyJournal of the American College of Emergency Physicians Open2688-11522020-08-011463364110.1002/emp2.12089Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysisEllen Crowe0Stacia M. DeSantis1Austin Bonnette2Jan O. Jansen3Jose‐Miguel Yamal4John B. Holcomb5Claudia Pedroza6John A. Harvin7Marisa B. Marques8Elenir B.C. Avritscher9Henry E. Wang10McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USADepartment of Biostatistics and Data Science The University of Texas Health Science Center at Houston Houston Texas USADepartment of Emergency Medicine The University of Texas Health Science Center at Houston Houston Texas USADepartment of Surgery University of Alabama at Birmingham Birmingham Alabama USADepartment of Biostatistics and Data Science The University of Texas Health Science Center at Houston Houston Texas USADepartment of Surgery University of Alabama at Birmingham Birmingham Alabama USADepartment of Pediatrics The University of Texas Health Science Center at Houston Houston Texas USADepartment of Surgery The University of Texas Health Science Center at Houston Houston Texas USADepartment of Pathology University of Alabama at Birmingham Birmingham Alabama USADepartment of Pediatrics The University of Texas Health Science Center at Houston Houston Texas USADepartment of Emergency Medicine The University of Texas Health Science Center at Houston Houston Texas USAAbstract Background Patients with hemorrhagic shock from trauma often require balanced blood product transfusion with red blood cells, plasma, and platelets. Resuscitation with whole blood resuscitation is becoming a common practice. We performed a systematic review and meta‐analysis of studies comparing whole blood transfusion with balanced component therapy in patients suffering from traumatic hemorrhagic shock. Methods We searched MEDLINE Ovid, EMBASE, and the Cochrane Library for human studies comparing whole blood with component blood therapy published from January 2007 to June 2019. We included studies from both civilian and military settings and that reported 24‐hour, in‐hospital, or 30‐day mortality. We followed the Preferred Reporting Items in Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, assessing study quality, publication bias, and heterogeneity. We used meta‐analytic models to determine the associations (odds ratio [OR] with 95% confidence interval [CI]) between whole blood transfusion and (1) 24‐hour mortality, and (2) in‐hospital or 30‐day mortality. Results A total of 1759 identified studies, 12 (reporting on n = 8431 patients) met inclusion criteria. There was heterogeneity in the design, setting, interventions, and outcomes of the studies. On meta‐analysis, whole blood transfusion was not associated with 24‐hour mortality (OR = 0.83; 95% CI = 0.56–1.24) or in‐hospital/30‐day mortality (OR = 0.79; 95% CI = 0.48–1.31). Conclusion In this systematic review and meta‐analysis, compared with conventional component transfusion, whole blood was not associated with 24‐hour or in‐hospital mortality. However, there were important limitations with and heterogeneity among the primary studies. Additional study is needed to determine the effectiveness of whole blood.https://doi.org/10.1002/emp2.12089blood productshemorrhagemeta‐analysissystematic reviewtransfusion |
| spellingShingle | Ellen Crowe Stacia M. DeSantis Austin Bonnette Jan O. Jansen Jose‐Miguel Yamal John B. Holcomb Claudia Pedroza John A. Harvin Marisa B. Marques Elenir B.C. Avritscher Henry E. Wang Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis Journal of the American College of Emergency Physicians Open blood products hemorrhage meta‐analysis systematic review transfusion |
| title | Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis |
| title_full | Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis |
| title_fullStr | Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis |
| title_full_unstemmed | Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis |
| title_short | Whole blood transfusion versus component therapy in trauma resuscitation: a systematic review and meta‐analysis |
| title_sort | whole blood transfusion versus component therapy in trauma resuscitation a systematic review and meta analysis |
| topic | blood products hemorrhage meta‐analysis systematic review transfusion |
| url | https://doi.org/10.1002/emp2.12089 |
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