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Essentials of emergency transfusion—The complement to stop the bleed

Lewis, Meghan MD; Shulman, Ira MD; Hudgins, Jay DO; Moore, Ernest E. MD; Inaba, Kenji MD

Journal of Trauma and Acute Care Surgery: August 2019 - Volume 87 - Issue 2 - p 420–429
doi: 10.1097/TA.0000000000002298

ABSTRACT Over the past decade, the shift toward damage control surgery for bleeding trauma patients has come with an increased emphasis on optimal resuscitation. Two lifesaving priorities predominate: to quickly stop the bleed and effectively resuscitate the hemorrhagic shock. Blood is separated into components for efficient storage and distribution; however, bleeding patients require all components in a balanced ratio. A variety of blood products are available to surgeons, and these products have evolved over time. This review article describes the current standards for resuscitation of bleeding patients, including characteristics of all available products. The relevant details of blood donation and collection, blood banking, blood components, and future therapies are discussed, with the goal of guiding surgeons in their emergency transfusion practice.

From the Division of Trauma and Surgical Critical Care, Department of Surgery (M.L., K.I.), Department of Pathology, LAC+USC Medical Center (I.S., J.H.), University of Southern California, Los Angeles, California; Department of Surgery (E.E.M.), University of Colorado Denver, School of Medicine, Aurora; and Department of Surgery (E.E.M.), Denver Health Medical Center, Denver, Colorado

Submitted: August 29, 2018, Revised: December 5, 2018, Accepted: December 23, 2018, Published online: April 1, 2019.

Address for reprints: Meghan Lewis, MD, Division of Trauma and Surgical Critical Care, Department of Surgery, LAC+USC Medical Center, University of Southern California, Rm C5L100, Inpatient Tower (C), 1200 N. State Street, Los Angeles, CA 90033; email:

Online date: April 2, 2019

© 2019 Lippincott Williams & Wilkins, Inc.