{"id":30970,"date":"2026-09-14T04:14:00","date_gmt":"2026-09-13T20:14:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30970"},"modified":"2026-09-14T05:47:35","modified_gmt":"2026-09-13T21:47:35","slug":"icu-management-practice-%e6%b3%95%e5%9b%bd%e5%86%9b%e9%98%9f%e5%a4%a7%e8%a7%84%e6%a8%a1%e4%bd%9c%e6%88%98%e8%a1%8c%e5%8a%a8%e4%b8%ad%e7%9a%84%e8%be%93%e8%a1%80%e5%8e%9f%e5%88%99","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30970","title":{"rendered":"[ICU Management &#038; Practice]: \u6cd5\u56fd\u519b\u961f\u5927\u89c4\u6a21\u4f5c\u6218\u884c\u52a8\u4e2d\u7684\u8f93\u8840\u539f\u5219"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">French Military Transfusion Doctrine for Large-Scale Combat Operations<\/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, 29 Apr 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\/v1777465012\/cw\/00132510_cw_image_admin_4ef934b79ef0ec768ea8321586a34966.webp?_a=BAAABnBs\" alt=\"\"\/><\/figure>\n\n\n\n<p>A consensus article presents a revised French military transfusion doctrine tailored for large-scale combat operations (LSCO), addressing the substantial clinical, logistical, and organisational challenges posed by high-intensity warfare.<\/p>\n\n\n\n<p>The authors begin by situating the need for reform within the evolving geopolitical context, particularly the resurgence of large-scale conflict. LSCO are characterised by high casualty volumes, extended evacuation times, and constrained logistics, often disrupting the \u201cGolden Hour\u201d principle of trauma care. Haemorrhage remains the leading cause of preventable death in combat, accounting for the majority of early fatalities. While early blood-based resuscitation is important, it is emphasised as a temporising measure rather than a substitute for definitive haemorrhage control.<\/p>\n\n\n\n<p>To develop the revised doctrine, eight experienced military physicians across relevant specialties were involved. Conducted between November 2024 and April 2025, the process included three iterative rounds and addressed eleven thematic domains. Recommendations were derived from existing doctrine, operational experience, and international literature, but the authors stress that the outcome reflects expert consensus on feasibility and safety rather than definitive clinical superiority of specific transfusion strategies.<\/p>\n\n\n\n<p>A central finding is the dramatic increase in transfusion demand anticipated in LSCO. Modelling suggests that if 100 casualties are managed daily, approximately 20% may require transfusion, with up to eight units per patient, resulting in an estimated need of 160 whole-blood equivalents per day. This represents a substantial escalation compared with low-intensity conflicts (LIC), where annual transfusion volumes were relatively modest.<\/p>\n\n\n\n<p>Qualitatively, the doctrine prioritises cold-stored whole blood (CS-WB) for forward resuscitation due to its logistical simplicity and ability to deliver balanced haemostatic components in a single product. However, the authors acknowledge that evidence supporting whole blood over component therapy remains limited and largely observational. As such, its prioritisation is based on operational practicality rather than proven superiority. Universal blood products, particularly group O, are emphasised for early use, while component-based therapy remains essential at higher levels of care.<\/p>\n\n\n\n<p>The doctrine introduces major organisational adaptations. Pre-deployment preparation requires all soldiers to undergo blood typing and infectious screening, enabling them to serve as both donors and recipients. In theatre, a new entity\u2014the French Military Blood Institute Operational Medical Unit (FMBI-OMU)\u2014is established as the central hub for blood collection, storage, and distribution. This unit also facilitates local production of CS-WB and ensures interoperability with NATO standards.<\/p>\n\n\n\n<p>Transfusion practices are decentralised but standardised across roles of care. At Role 1 (forward positions), transfusion can be initiated using universal products, even by trained nurses under predefined criteria, reflecting the need for rapid intervention in austere conditions. Role 2 prioritises whole blood with supplementary components, while Role 3 facilities employ full component therapy guided by laboratory support. The doctrine also allows controlled deviations from peacetime standards\u2014such as extended storage limits\u2014in extreme circumstances, provided these are governed by formal risk-management and haemovigilance processes.<\/p>\n\n\n\n<p>Haemovigilance and traceability remain central throughout the system. The FMBI oversees monitoring of adverse events, ensures traceability of all blood products, and supports post-transfusion analysis. Robust documentation and digital tracking are emphasised, even in degraded environments, to maintain safety and accountability.<\/p>\n\n\n\n<p>The discussion places this doctrine within historical and international context. French practice has evolved from reliance on lyophilised plasma and component therapy towards earlier, forward transfusion strategies, including whole blood. However, the authors caution that much of the supporting evidence is susceptible to bias, and randomised trials have not demonstrated clear mortality benefits for specific transfusion ratios. Consequently, the doctrine adopts a pragmatic approach that balances operational feasibility with cautious interpretation of evidence.<\/p>\n\n\n\n<p>The article also highlights the importance of civil\u2013military collaboration. Civilian systems typically operate on a \u201cjust-in-time\u201d model, whereas military systems require \u201cjust-in-case\u201d preparedness. Integrating these approaches is essential to ensure surge capacity during LSCO. Harmonisation of standards, shared stockpiling, and coordinated planning across Europe are identified as key priorities.<\/p>\n\n\n\n<p>International comparisons reveal convergence around three principles: early transfusion close to the point of injury, balanced resuscitation, and maintenance of safety standards. Differences lie in implementation strategies, such as prepositioned blood stocks versus walking blood banks. The French system distinguishes itself through centralised governance, strong haemovigilance, and doctrinal coherence across the care continuum.<\/p>\n\n\n\n<p>The revised French transfusion doctrine for LSCO represents a shift towards a flexible, forward-deployed, and whole-blood-centred system, supported by centralised oversight and rigorous haemovigilance. It aims to enhance survival by enabling earlier haemostatic resuscitation while maintaining safety under the constraints of large-scale combat, though further research is needed to strengthen the evidence base underpinning these practices.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/link.springer.com\/article\/10.1186\/s13054-026-05862-9\" target=\"_blank\" rel=\"noreferrer noopener\">Critical Care<\/a><br \/>Image Credit: iStock<\/p>\n","protected":false},"excerpt":{"rendered":"<p>French Military Transfusion Doctrine for Large-Scale Co [&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\/30970"}],"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=30970"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30970\/revisions"}],"predecessor-version":[{"id":30971,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30970\/revisions\/30971"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30970"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30970"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30970"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}