Article thumbnail

Optimizing the use of blood products in trauma care

By John R Hess and Seppo Hiippala


Blood transfusion has been used to treat the injured since the US Civil War. Now, it saves the lives of tens of thousands of injured patients each year. However, not everyone who receives blood benefits, and some recipients are injured by the transfusion itself. Effective blood therapy in trauma management requires an integration of information from diverse sources, including data relating to trauma and blood use epidemiology, medical systems management, and clinical care. Issues of current clinical concern in highly developed trauma systems include how to manage massive transfusion events, how to limit blood use and so minimize exposure to transfusion risks, how to integrate new hemorrhage control modalities, and how to deal with blood shortages. Less developed trauma systems are primarily concerned with speeding transport to specialized facilities and assembling trauma center resources. This article reviews the factors that effect blood use in urgent trauma care

Topics: Review
Publisher: BioMed Central
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (1964). Blood Program in World War II.
  2. (2003). Blood substitutes: the future is now.
  3. (1968). CE: Clinical experience with the use of frozen blood in combat casualties.
  4. (2004). Current status of blood component therapy in surgical critical care. Curr Opin Crit Care
  5. (1995). Dextran and hydroxyethyl starch interfere with fibrinogen assays. Blood Coagul Fibrinolysis
  6. (1991). EP: Marked temperature dependence of the platelet calcium signal induced by human von Willebrand factor. Blood
  7. for Disease Control and Prevention: Web-based Injury Statistics Query and Reporting System (WISQARS).
  8. (1936). From a Surgeon’s Journal.
  9. (2002). Greenwalt TJ: Storage of red blood cells: new approaches. Transfus Med Rev
  10. GS: The role of hemoglobin solutions in massive transfusion.
  11. (2004). Hess JR: Blood transfusion rates in the care of acute trauma. Transfusion
  12. (2003). Hess JR: Treating coagulopathy in trauma patients. Transfus Med Rev
  13. (2004). HG: Training physicians in the discipline of transfusion medicine:
  14. (2000). History and development of trauma care in the United States. Clin Orthop Relat Res
  15. (1997). JR: New technologies in hemorrhage control. Curr Opin Crit Care
  16. (1999). Martinowitz U: Treatment of traumatic bleeding with recombinant factor VIIa. Lancet
  17. (2003). Mattox KL: Minimizing dilutional coagulopathy in exsanguinating hemorrhage: a computer simulation.
  18. (2005). NovoSeven Trauma Study Group: Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials.
  19. (2003). Organization: World Health Report 2003: Shaping the Future. Geneva, Switzerland: World Health Organization;
  20. (2000). PJ: Management of massive blood loss: a template guideline.
  21. (1997). Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidosis revisited.
  22. (1995). PT: Epidemiology of trauma deaths: a reassessment.
  23. (1998). Replacement of massive blood loss. Vox Sang
  24. (2004). Road traffic injury: a global health scourge: a review for World Health Day
  25. (2004). Scalea TM: Factor VIIa for correction of traumatic coagulopathy.
  26. (2004). Strategies for transfusion therapy. Best Pract Res Clin Anaesthesiol
  27. (1999). Ten Cate H: Disseminated intravascular coagulation.
  28. (2003). The effect of temperature and pH on the activity of factor VIIa: implications for the efficacy of high-dose factor VIIa in hypothermic and acidotic patients.
  29. (1975). The use of whole blood and blood volume expanders in U.S. military medical facilities in Vietnam.
  30. (2003). Thomas MJG: Blood use in war and disaster: lessons from the last century. Transfusion
  31. (2002). TM: Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality.
  32. (2005). Transfusion practice in massively bleeding patients: time for a change? Vox Sang
  33. (2005). Uncross-matched blood is unnecessary. Hosp Med
  34. (2004). Update on alternative oxygen carriers. Vox Sang
  35. (2002). Updates in the management of severe coagulopathy in trauma patients. Intensive Care Med
  36. (1999). Yetisir E: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group.
  37. (1997). Zonies DH: The damage control sequence and underlying logic. Surg Clin North Am

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.