Research tagged [surgery]

Low-Titer Group O Whole Blood Resuscitation in Civilian Massive Hemorrhage: An Evidence Synthesis and Implementation Review

Massive hemorrhage remains a leading cause of preventable death in trauma. Traditional resuscitation protocols, often based on 1:1:1 component therapy (packed red blood cells, fresh frozen plasma, platelets), aim to mitigate trauma-induced coagulopathy. However, logistical challenges and delays associated with component preparation have prompted exploration of alternative strategies. Low-titer group O whole blood (LTOWB) has emerged as a promising option, offering a physiologically balanced resuscitation product. This paper synthesizes expert clinical perspectives and recent trial data regarding the transition to LTOWB in civilian trauma centers. Findings indicate that a hybrid approach, utilizing LTOWB for initial resuscitation units, can accelerate balanced resuscitation and improve hemostatic parameters. While logistical hurdles such as shelf life and inventory management persist, strategies for mitigation have been developed. Furthermore, LTOWB significantly reduces administrative errors and simplifies resuscitation protocols in high-stress environments. The role of dried plasma as a pre-hospital adjunct, particularly in settings with prolonged transport times or challenging cold chain logistics, is also discussed. The collective evidence suggests that LTOWB represents a valuable advancement in massive hemorrhage resuscitation, warranting careful consideration for integration into institutional protocols.