Evidence map›Paper›PMID 42150044›Full record

Trial reportThe New England journal of medicine2026

Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage.

Jason L Sperry, Francis X Guyette, Bryan A Cotton, James F Luther, Richard B Utarnachitt, Matthew E Kutcher, Brian J Daley, Allan B Peetz, Mayur B Patel, Michael D Goodman and 22 more

Registry-linked trialAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04684719 (Type O Whole Blood and Assessment of Age During Prehospital Resuscitation), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04684719 phase3completednot on this map

Type O Whole Blood and Assessment of Age During Prehospital Resuscitation (TOWAR) Trial

TypeinterventionalSponsorJason SperryRan2022 to 2025Enrolled1,020ConditionsHemorrhagic Shock, Traumatic InjuryArmslow titer whole blood, Standard Care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Jason L SperryDivision of Trauma and General Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh.
Francis X GuyetteDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh.
Bryan A CottonDepartment of Surgery, University of Texas Health Science Center, Houston.
James F LutherUniversity of Pittsburgh School of Public Health, Pittsburgh.
Richard B UtarnachittDepartment of Emergency Medicine, University of Washington, Seattle.
Matthew E KutcherDepartment of Surgery, University of Mississippi, Jackson.ORCID 0000-0003-4566-5359
Brian J DaleyDepartment of Surgery, University of Tennessee Health Science Center, Knoxville.
Allan B PeetzDepartment of Surgery, Vanderbilt University Medical Center, Nashville.
Mayur B PatelDepartment of Surgery, Vanderbilt University Medical Center, Nashville.ORCID 0000-0001-5230-0871
Michael D GoodmanDepartment of Surgery, University of Cincinnati, Cincinnati.
Jeffrey A ClaridgeMetroHealth System, Case Western Reserve University School of Medicine, Cleveland.
Nimitt PatelMetroHealth System, Case Western Reserve University School of Medicine, Cleveland.
Brian G HarbrechtDepartment of Surgery, University of Louisville, Louisville, KY.
Zain G HashmiDepartment of Surgery, University of Alabama at Birmingham, Birmingham.
Ryan ZarychanskiDepartment of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Canada.
Matthew D NealDivision of Trauma and General Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh.ORCID 0000-0001-8931-6236
Mark H YazerDivision of Transfusion Medicine, Department of Pathology, University of Pittsburgh, Pittsburgh.
Christian Martin-GillDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh.
Laura E VincentDivision of Trauma and General Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh.
Ashley M HarnerDivision of Trauma and General Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh.
David E MeyerDepartment of Surgery, University of Texas Health Science Center, Houston.
Andrew J LatimerDepartment of Emergency Medicine, University of Washington, Seattle.
Bryce R RobinsonDepartment of Surgery, University of Washington, Seattle.
Catherine L McKnightDepartment of Surgery, University of Tennessee Health Science Center, Knoxville.
William R HinckleyDepartment of Surgery, University of Cincinnati, Cincinnati.
Keith R MillerDepartment of Surgery, University of Louisville, Louisville, KY.
Jan O JansenDepartment of Surgery, University of Alabama at Birmingham, Birmingham.
Douglas MartinDepartment of Emergency Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Canada.
Erin E FoxDepartment of Surgery, University of Texas Health Science Center, Houston.ORCID 0000-0002-8843-5054
Bedda L Rosario-RiveraUniversity of Pittsburgh School of Public Health, Pittsburgh.
Stephen R WisniewskiUniversity of Pittsburgh School of Public Health, Pittsburgh.
TOWAR Study Group

Funding

Mechanistic Elucidation and Targeted Therapy of Platelet Dysfunction After TraumaR35GM119526 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEAL, MATTHEW D · 2016 to 2025
$3.9M
NIGMS NIH HHS R35 GM119526U.S. Department of Defense W81XWH-20-F-0383
6 · The paper itself

Abstract

backgroundBlood transfusion before arrival at a hospital reduces mortality from traumatic hemorrhage and shock. Whether transfusion with whole blood is more beneficial than transfusion with blood components is uncertain, as are the effects of the length of time that blood products are in storage between donation and transfusion.

methodsIn this pragmatic, multicenter, phase 3, cluster-randomized trial, we assigned 44 air medical bases in a 2:1 ratio to the use of up to 2 units of whole blood or as-indicated blood components (plasma, red cells, or both) for prehospital transfusion in trauma patients during 1-month blocks. The primary outcome was death from any cause within 30 days after randomization. An observational substudy assessed outcomes according to the storage age of whole blood.

resultsOf 1020 eligible patients transported to hospitals by the air bases, 715 were assigned to receive whole blood and 305 to receive blood components; 695 and 298, respectively, were included in the primary analysis. Mortality at 30 days was 25.9% in the whole-blood group and 20.5% in the component group (adjusted odds ratio, 1.24; 95% confidence interval [CI], 0.87 to 1.76; P = 0.24). No substantial between-group differences in adverse events were observed. In the observational substudy, 30-day mortality was 27.1% among 210 patients who received whole blood with a storage age of 15 to 21 days and 26.4% among 443 patients who received whole blood with a storage age of 1 to 14 days (adjusted odds ratio, 0.99; 95% CI, 0.74 to 1.32).

conclusionsIn injured patients with hemorrhagic shock, the use of whole blood for prehospital transfusion did not result in lower 30-day mortality than the use of blood components. (Funded by the Defense Health Agency Research Technology Portfolio Management, Combat Casualty Portfolio; TOWAR ClinicalTrials.gov number, NCT04684719.).

Indexed as

Air AmbulancesBlood TransfusionHemorrhageResuscitationShock, HemorrhagicWounds and InjuriesABO Blood-Group SystemAdultBlood Component TransfusionBlood PreservationFemaleHospital MortalityHumansMaleMiddle AgedTime FactorsABO Blood-Group System

Identifiers

PMID42150044
PMCPMC13313084

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.