Transfusion Management in Trauma: What is Current Best Practice?

Authors: Beiriger, J; Silver, D; Lu, L; Brown, JB

Affiliations: Division of Trauma and General Surgery, Department of Surgery, University of Pittsburgh Medical Center, PUH F1266.2, 200 Lothrop Street, Pittsburgh, PA, United States

Publication: Current Surgery Reports ; 2023 ; 11. 43–54

Abstract: PURPOSE OF REVIEW: In the past few years, transfusion strategies in trauma have changed dramatically. We aim to define current practices, explore the evidence leading to these shifts, and identify areas of contemporary research within this field. Recent Findings: Some major shifts include initiating blood products in the prehospital setting and favoring whole blood rather than individual blood components. Additional improvements include expanding trauma resuscitation to include AB plasma in untyped patients, several adjuncts given as part of massive transfusion protocols, and utilizing thromboelastography for individually tailored resuscitation. These practices remain at the forefront of trauma transfusion research with several trials completed and ongoing to establish their safety and practical value. Summary: The degree of change over just the past few years highlights the opportunity for improvement in the field. Despite being standard of care for over a century, transfusion in trauma is still evolving to optimize patient care.