Use of Whole Blood in Massive Transfusions

[SMILLER]

The idea is that whole blood was always the best way to accommodate massively bleeding patients---plasma, RBCs and platelets all in one shot so to speak.  And that the common use of component therapy over the years is more due to convenience than otherwise. There have been a few retrospective studies out that seem to suggest that the use of whole blood in these patients leads to better outcomes.  On the other hand, maintaining an inventory of WB for the occasional massive transfusion patient seems impractical.   Here's one article:

http://www.mayoclinic.org/medical-professionals/clinical-updates/trauma/whole-blood-transfusions-reduce-mortality-in-massively-hemorrhaging-patients

I am curious if some of our more astute PathLabTalk associates have any opinions on this topic?

Thanks, Scott

[Smarty pants]

We learn something new from every war.  Plastic bags are better than glass bottles.  Additive solution prolongs the life of RBCs.  It seems that the lessons learned in the current gulf conflict is the valuable use of whole blood in traumas.  There are multiple studies, and they're pretty compelling.   That said, I don't see much change in maintaining an inventory of WB.  I see the change in ordering more FFP along with the pRBCs to treat traumas in order to get the component to be "more like" whole blood.  The benefits of freezing the plasma are pretty apparent.
There is also some interesting research being done on platelets stored at 4c.  They have a longer shelf-life (the cold slows down their metabolism a bit).  And they're already slightly activated, so they work faster when transfused to plug the holes.  I think the DoD is actively doing some research on this, and there are a few articles published.  Still a lot of work towards the feasibility on how this would be managed, because it is a whole new product with a specific indication.  It would need ISBT products, FDA approval... we're still years away.... but it's interesting to read about.