"Whole Blood" Versus "Pieces of Blood"

It didn't generally matter in this trial.

Transfusion trends in traumatic hemorrhage have changed over the course of my career. Originally, blood was simply packed red cells. Then it became important to add plasma. Then the ratio of plasma became important. Now, “whole blood” is in vogue.

But, this trial involving prehospital transfusion following major trauma found no difference between whole blood and balanced blood components for their primary outcome:

“But what’s the breakdown of the massive transfusion component” you ask, and thus some secondary outcomes:

Prothrombin times were longer in the whole blood component group on arrival, but it is doubtful this translated into any meaningful differences in primary, secondary, or safety outcomes.

It’s possible limitations in the trial did not enroll the proper cohort from which to detect an advantage to whole blood – but it’s probably more likely there simply isn’t one.