Jefferson Regional in Pine Bluff has recently treated trauma patients using whole blood, becoming the first hospital in the state to successfully use this method.
Each patient had life-threatening bleeding. “This represents the first use of whole blood in the State of Arkansas,” said Michelle Eckert, M.D., a general surgeon and medical director of the Jefferson Regional Level III Trauma Center. “This new therapy helped us to control the bleeding and prevent death in these patients, who have recovered and are doing well.”
Whole blood transfusions were used in the 1940s, until techniques came along that allowed blood to be separated and preserved for longer time periods. Once the blood was donated, it was split into red blood cells, plasma, and cells that help the blood clot – the platelets – which are then given separately to patients as individual transfusions. As a result, whole blood was all but forgotten. However, new research by the military, from the battlefields of Iraq and Afghanistan, has shown an advantage to early transfusion of whole blood, containing all three components in one bag. “By using whole blood first, rather than components, the military has shown that deaths from bleeding were reduced and deadly thinning of the patient’s blood was prevented,” explained Charles Mabry, M.D., a general surgeon at Jefferson Regional and Vice-Chair of the Governor’s Trauma Advisory Committee for Arkansas. “Using that information, our trauma team started making plans last year to use whole blood for emergency transfusion.”
The advantage of using whole blood is that early on, the patient receives not only red blood cells, which are needed to supply oxygen to the body, but they also quickly receive clotting factors from plasma and platelets, which slow or stop the hemorrhage better than the traditional component therapy. “While component therapy is great, it also takes some time to get the units ready and then to transfuse each one, in a process called massive transfusion protocol (MTP). With whole blood, we can immediately give two units with all of the clotting factors included, while the components needed for the MTP are being readied, said Mabry.”
Whole blood transfusions are now being used in the San Antonio, TX region, as first-line transfusions for trauma patients, but its use has not been extended to Arkansas until now. “Up until now, we have had two powerful tools to help save lives from bleeding: the MTP and liquid plasma,” said J.R. Taylor, M.D., a critical care surgeon at Jefferson Regional. “Both of these are examples of component therapy, and both have been used successfully at Jefferson Regional for several years to help resuscitate bleeding patients. Now, however, with whole blood being available, we have a third great tool to help save lives.”
Over the last two years, Jefferson Regional Trauma Center handled over 1200 major trauma cases including 107 that required blood transfusions.