ArticleTrauma surgery & acute care open2024
Evolution of whole blood trauma resuscitation in childbearing age females: practice patterns and trends.
Article in Trauma surgery & acute care open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Prehospital blood transfusion coalition core competencies for emergency medical services personnel.Trauma surgery & acute care open · 2026Article
- Article
- A national database review of whole blood use among females of childbearing potential experiencing traumatic hemorrhage.Transfusion · 2025Article
- Sex-based disparities in low-titer O whole blood utilization and mortality among severely injured trauma patients.Transfusion · 2025Article
- Prehospital blood transfusion coalition clinical practice guideline for civilian emergency medical services.Trauma surgery & acute care open · 2025Article
- Mitigating the risk of low-titer group O-positive whole blood resuscitation in females of childbearing potential: toward a systems-based approach.Trauma surgery & acute care open · 2024Article
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16 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The use of low titer group O whole blood (LTOWB) for resuscitation of patients with traumatic hemorrhage is becoming increasingly common. Practices regarding the administration of RhD-positive LTOWB to childbearing age females (CBAFs) vary between institutions due to concerns about RhD alloimmunization. This study examined practices related to LTOWB transfusion as they pertain to age and sex. Methods: This was a secondary analysis of the Shock, Whole blood, and Assessment of TBI (traumatic brain injury) trial, a prospective, multicenter observational cohort study where outcomes following LTOWB transfusion were analyzed at seven level 1 trauma centers between 2018 and 2021, as well as a survey on transfusion practices at these centers conducted in 2023. The proportion of patients who received LTOWB or components was examined over the course of the study and grouped by age and sex, and the RhD group of injured CBAFs was documented. Results: A total of 1046 patients were evaluated: 130 females aged <50 years (CBAFs), 77 females aged ≥50 years; 661 males aged <50 years, and 178 males aged ≥50 years. Among them, 26.2% of CBAFs received RhD-positive LTOWB, whereas 57.1%-66.3% of other sex/age groups received LTOWB. The proportion of CBAFs who received LTOWB increased significantly throughout the 4 years of this study. Except for older women in years 2 and 4, CBAFs were significantly less likely to receive LTOWB than all other groups for the study period and individual years. Among the 33 CBAFs who received LTOWB and for whom an RhD type was available, 4/33 (12.1%) were RhD-negative, while 9/95 (9.5%) CBAFs who received component therapy were RhD-negative. RhD blood product selection practices varied considerably between institutions. Conclusions: Many institutions transfused LTOWB to CBAFs. Policies regarding RhD product selection varied. Of the total cohort, the proportion of RhD-negative CBAFs who received LTOWB increased over time but remained lower than all other groups. Level of evidence: 3.
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