{"id":30485,"date":"2026-03-30T04:17:00","date_gmt":"2026-03-29T20:17:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30485"},"modified":"2026-03-30T05:43:49","modified_gmt":"2026-03-29T21:43:49","slug":"icu-management-practice-%e5%88%9b%e4%bc%a4%e6%80%a7%e5%87%ba%e8%a1%80%e6%82%a3%e8%80%85%e9%99%a2%e5%89%8d%e8%be%93%e6%b3%a8%e5%85%a8%e8%a1%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30485","title":{"rendered":"[ICU Management &#038; Practice]: \u521b\u4f24\u6027\u51fa\u8840\u60a3\u8005\u9662\u524d\u8f93\u6ce8\u5168\u8840"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Prehospital Whole Blood in Traumatic Haemorrhage<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Wed, 18 Mar 2026<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/f_auto\/q_90\/fl_lossy\/v1773834990\/cw\/00132266_cw_image_admin_c1d6bf71ddabf4709ce6f000052931cd.webp?_a=BAAABnBs\" alt=\"\"\/><\/figure>\n\n\n\n<p>Findings from the study of whole blood in frontline trauma (SWiFT Trial) were presented&nbsp;at the 45th ISICEM Congress in Brussels.<\/p>\n\n\n\n<p>The clinical trial evaluated whether prehospital transfusion of whole blood improves outcomes compared with standard component therapy in patients with life-threatening traumatic haemorrhage. The study addressed a critical evidence gap, as whole-blood transfusion has gained increasing interest in trauma care but lacks robust large-scale trial data supporting its clinical effectiveness and safety.<\/p>\n\n\n\n<p>The trial was conducted across 10 air ambulance services in England, with patients transported to 19 hospitals. Eligible participants were individuals of any age with traumatic injury requiring prehospital transfusion for suspected major haemorrhage.&nbsp;Patients&nbsp;were excluded&nbsp;if&nbsp;vascular access could not be established, if they&nbsp;had&nbsp;declined transfusion, or if they had already received blood products before air ambulance&nbsp;arrival.<\/p>\n\n\n\n<p>Participants were randomised via pre-prepared transfusion boxes to receive either up to two units of leukocyte-depleted, low-titre group O whole blood or standard care consisting of up to two units each of red blood cells and plasma.&nbsp;<\/p>\n\n\n\n<p>The primary outcome was a composite of death from any cause or massive transfusion within 24 hours of randomisation. Massive transfusion&nbsp;was defined&nbsp;as at least 10 units of blood products in adults or an equivalent weight-based threshold in children. Secondary outcomes included mortality at multiple time points (6 hours, 24 hours, 30 days, and 90 days), incidence of massive transfusion, organ support\u2013free days, length of hospital and critical care stay, transfusion requirements, coagulation parameters, and safety outcomes such as thrombotic events and transfusion reactions.<\/p>\n\n\n\n<p>A total of 942 patients&nbsp;were randomised, and after exclusions,&nbsp;641 participants were included&nbsp;in the modified intention-to-treat analysis. Baseline characteristics were well balanced between groups, with most patients being young males sustaining blunt trauma and having high injury severity scores.<\/p>\n\n\n\n<p>The primary outcome occurred in 48.7% of patients in the whole-blood group and 47.7% in the standard-care group, showing no statistically significant difference. These findings were consistent across per-protocol and sensitivity analyses, as well as across predefined subgroups, including injury severity, presence of traumatic brain injury, and mechanism of injury.<\/p>\n\n\n\n<p>Secondary outcomes also showed no meaningful differences between the two groups. Mortality rates at all assessed time points (6 hours to 90 days) were similar. The proportion of patients requiring massive transfusion within 24 hours did not differ significantly. Measures of organ support,&nbsp;duration of hospitalisation, and total blood product use were likewise comparable.<\/p>\n\n\n\n<p>One notable difference&nbsp;was observed&nbsp;in coagulation parameters: a greater proportion of patients in the whole-blood group had a prolonged prothrombin time on hospital arrival (40.7% vs 30.5%). However, this laboratory finding did not translate into differences in clinical outcomes and&nbsp;was considered&nbsp;of uncertain clinical significance. The authors suggested that this may reflect the older age of plasma within stored whole blood compared with fresher plasma used in standard care, as coagulation factor activity declines over time during storage.<\/p>\n\n\n\n<p>Safety outcomes were broadly similar between groups. Slightly fewer serious adverse events occurred in the whole-blood group (31 vs 37), and no transfusion-related adverse events&nbsp;were reported&nbsp;in this group compared with two in the standard-care group. Rates of thrombotic complications, including pulmonary embolism, deep vein thrombosis, stroke, and myocardial infarction, were comparable, indicating no increased risk associated with whole-blood transfusion.<\/p>\n\n\n\n<p>The study highlights several practical considerations. Whole blood offers logistical advantages in the prehospital setting, including simplified storage, faster administration, reduced equipment needs, and improved feasibility in patients with limited vascular access. These factors have driven interest in its use, particularly in austere or time-critical environments. However, the trial findings suggest that these operational benefits do not translate into improved clinical outcomes when limited to two units administered prehospital.<\/p>\n\n\n\n<p>In conclusion, this trial found that prehospital transfusion of up to two units of whole blood was not superior to standard component therapy in reducing death or the need for massive transfusion within 24 hours in patients with traumatic haemorrhage. Clinical outcomes and safety profiles were similar between groups. These findings suggest that while whole blood may offer logistical advantages,&nbsp;its routine use in civilian prehospital trauma systems should be carefully weighed&nbsp;against&nbsp;considerations of cost, supply, and overall system impact.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa2516043\" target=\"_blank\" rel=\"noreferrer noopener\">NEJM<\/a><\/p>\n\n\n\n<p>Image Credit: iStock<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prehospital Whole Blood in Traumatic Haemorrhage Findin [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30485"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30485"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30485\/revisions"}],"predecessor-version":[{"id":30487,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30485\/revisions\/30487"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30485"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30485"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30485"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}