A narrative review in this issue considers the use of whole blood resuscitation during massive hemorrhage in the civilian sector based on the interpretation of military data. Retrospective studies have illustrated the benefits of whole blood, namely, the preservation of physiological proportions and viability of platelet function and coagulation. Implementation of whole blood protocols at civilian trauma centers requires an intense education campaign spanning personnel and staff from the emergency department to the operating room and critical care unit. Additionally, it mandates a coordinated program of acquisition from the local blood supplier. Limitations of our ability to apply knowledge gained from the military studies include retrospective designs, selection and survivor bias, and comparisons to historical controls.
1. Pivalizza EG, Stephens CT, Sridhar S, et alWhole blood for resuscitation in adult civilian trauma in 2017: a narrative review. Anesth Analg. 2018;127:157–162.