Adopted from the journal Anesteziologie a intenzivní medicína with the consent of Editor-in-Chief prof. Dr. Jiří Málek (article DOI: 10.36290/aim.2024.022).
THE USE OF WHOLE BLOOD IN PATIENTS WITH MAJOR TRAUMA BLEEDING: SUMMARY AND CONSENSUS OF AN INTERDISCIPLINARY PANEL MEETING
Bláha Jan, Bohoněk Miloš, Černý Vladimír, Klugar Miloslav, Kočí Jaromír, Loužil Jan, Řeháček Vít, Truhlář Anatolij, Zýková Ivana
In the Czech Republic (CR), whole blood (WB) administration has been gradually introduced since 2020 and the practice is currently used in four trauma centres with emergency admissions and four air ambulance services. In view of the discussion on the effectiveness and safety of WB administration, an interdisciplinary panel met in December 2023 to formulate a common position on WB administration in CR. The panel was composed of experts nominated by the following professional societies of the Czech Medical Society of Jan Evangelista Purkyně: Czech Society of Haematology, Czech Society of Anaesthesiology, Resuscitation and Intensive Care Medicine Czech Society for Thrombosis and Haemostasis, Czech Society of Trauma Surgery, Czech Society for Blood Transfusion, Czech Society of Emergency and Disaster Medicine, Czech Society of Military Medicine and Czech Resuscitation Council. The panel agreed on six positions: 1/ WB is produced as a universal blood product "Whole blood deleukotized for universal administration" of blood group 0, with low anti-A/B IgM antibody titre and low risk of TRALI, 2/ The main benefit of WB administration in adult patients with life-threatening bleeding (LTB) may lie in its complexity and ease of use, 3/ The current state of expertise and scientific evidence on the subject does not allow to designate WB administration as the preferred method for the treatment of LTB, 4/ Whole blood administration is a possible alternative to existing treatment modalities for patients with WOC, 5/ The decision to implement a WB administration programme in a given healthcare facility depends on local conditions, 6/ Further evidence on the benefits and risks of WB administration is needed, the panel agrees on the appropriateness of conducting a national multicentre clinical trial focusing on the comparison of WB-based procedures with existing procedures.
Keywords: Whole Blood, Polytrauma, Massive bleeding
Received: April 1, 2024; Accepted: April 1, 2024; Published: September 5, 2024