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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

Year: 2021
Type: review
Abstract: This narrative review explores the pathophysiology, geographic variation, and historical developments 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.
DOI: 10.3390/jcm10020320
Authors: Mark Walsh, Ernest E. Moore, Hunter B. 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
Institutions: St. Joseph Regional Medical Center, Indiana University South Bend, Indiana University School of Medicine, Denver Health Medical Center, University of Colorado Health, University of Colorado Denver, Beacon Health System, Northwestern University, University of Maryland, Baltimore
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,376
OpenAlex ID: W3124046584
FWCI: 1.515
Cites: 130
Cited by: 38
Related to: 10