EARLY WHOLE BLOOD VS BALANCED TRANSFUSION IN TRAUMA: CLINICAL BENEFITS WITHOUT LABORATORY INFERIORITY drturkoglubaki@gmail.com

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EARLY WHOLE BLOOD VS BALANCED TRANSFUSION IN TRAUMA: CLINICAL BENEFITS WITHOUT LABORATORY INFERIORITY

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Turkey

Oral only

The whole blood (WB) transfusion has re-emerged as a resuscitation method in trauma care. While its superiority over isolated red blood cells is recognized, comparative data against balanced component therapy—using a 1:1:1 ratio of erythrocytes, plasma, and platelets—are limited. This study compares early clinical and laboratory outcomes of WB versus balanced transfusion in trauma patients.

A retrospective study included trauma patients who received transfusion within four hours of admission. Among analyzed 1508 trauma patients, 188 were included (78 WB and 110 balanced transfusion). Outcomes included ICU stay, total hospital stay, and in-hospital mortality. Regression analyses adjusted for Trauma Related Injury Severity Score (TRISS) and shock index. Changes in blood were also compared.

WB recipients had shorter ICU (6.3 vs. 7.4 days) and total hospital stays (12.6 vs. 14.2 days) than those receiving balanced transfusion. These differences remained significant after adjusting for trauma severity. Mortality did not differ significantly between groups. Regression analyses showed that changes in coagulation markers (APTT, PT) and platelet counts were primarily associated with trauma severity, not transfusion type. This indicates laboratory outcomes were not worse with WB, supporting its non-inferiority.

Early WB transfusion may reduce ICU and hospital stay compared to balanced component therapy, without compromising laboratory stability. These findings suggest WB is not inferior and may be clinically advantageous in selected trauma patients. Further prospective validation is warranted.