{"id":31209,"date":"2026-06-30T04:14:00","date_gmt":"2026-06-29T20:14:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31209"},"modified":"2026-06-30T05:41:37","modified_gmt":"2026-06-29T21:41:37","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%88%9b%e4%bc%a4%e5%87%ba%e8%a1%80%e6%82%a3%e8%80%85%e9%99%a2%e5%89%8d%e8%be%93%e6%b3%a8o%e5%9e%8b%e5%85%a8%e8%a1%80%e6%8a%a2%e6%95%91","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31209","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u521b\u4f24\u51fa\u8840\u60a3\u8005\u9662\u524d\u8f93\u6ce8O\u578b\u5168\u8840\u62a2\u6551"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/browse\/nejm-article-type\/original-article\">ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Jason L.\u00a0Sperry,\u00a0Francis X.\u00a0Guyette,\u00a0Bryan A.\u00a0Cotton,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med\u00a02026;394:2317-2328<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">DOI: 10.1056\/NEJMoa2602167<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">BACKGROUND<\/h3>\n\n\n\n<p>Blood transfusion before arrival at a hospital reduces mortality from traumatic hemorrhage and shock. Whether transfusion with whole blood is more beneficial than transfusion with blood components is uncertain, as are the effects of the length of time that blood products are in storage between donation and transfusion.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">METHODS<\/h3>\n\n\n\n<p>In this pragmatic, multicenter, phase 3, cluster-randomized trial, we assigned 44 air medical bases in a 2:1 ratio to the use of up to 2 units of whole blood or as-indicated blood components (plasma, red cells, or both) for prehospital transfusion in trauma patients during 1-month blocks. The primary outcome was death from any cause within 30 days after randomization. An observational substudy assessed outcomes according to the storage age of whole blood.<\/p>\n\n\n\n<p>RESULTS<\/p>\n\n\n\n<p>Of 1020 eligible patients transported to hospitals by the air bases, 715 were assigned to receive whole blood and 305 to receive blood components; 695 and 298, respectively, were included in the primary analysis. Mortality at 30 days was 25.9% in the whole-blood group and 20.5% in the component group (adjusted odds ratio, 1.24; 95% confidence interval [CI], 0.87 to 1.76; P=0.24). No substantial between-group differences in adverse events were observed. In the observational substudy, 30-day mortality was 27.1% among 210 patients who received whole blood with a storage age of 15 to 21 days and 26.4% among 443 patients who received whole blood with a storage age of 1 to 14 days (adjusted odds ratio, 0.99; 95% CI, 0.74 to 1.32).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster.jpg\"><img decoding=\"async\" loading=\"lazy\" width=\"792\" height=\"1024\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster-792x1024.jpg\" alt=\"\" class=\"wp-image-31210\" srcset=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster-792x1024.jpg 792w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster-232x300.jpg 232w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster-768x993.jpg 768w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmdo008568_poster.jpg 801w\" sizes=\"(max-width: 792px) 100vw, 792px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f1.webp\"><img decoding=\"async\" loading=\"lazy\" width=\"2640\" height=\"2629\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f1.webp\" alt=\"\" class=\"wp-image-31211\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-scaled.jpg\"><img decoding=\"async\" loading=\"lazy\" width=\"854\" height=\"1024\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-854x1024.jpg\" alt=\"\" class=\"wp-image-31212\" srcset=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-854x1024.jpg 854w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-250x300.jpg 250w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-768x921.jpg 768w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-1281x1536.jpg 1281w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f2-1708x2048.jpg 1708w\" sizes=\"(max-width: 854px) 100vw, 854px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-scaled.jpg\"><img decoding=\"async\" loading=\"lazy\" width=\"905\" height=\"1024\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-905x1024.jpg\" alt=\"\" class=\"wp-image-31213\" srcset=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-905x1024.jpg 905w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-265x300.jpg 265w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-768x869.jpg 768w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-1357x1536.jpg 1357w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_f3-1809x2048.jpg 1809w\" sizes=\"(max-width: 905px) 100vw, 905px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-scaled.jpg\"><img decoding=\"async\" loading=\"lazy\" width=\"582\" height=\"1024\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-582x1024.jpg\" alt=\"\" class=\"wp-image-31214\" srcset=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-582x1024.jpg 582w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-170x300.jpg 170w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-768x1352.jpg 768w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-873x1536.jpg 873w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-1164x2048.jpg 1164w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t1-scaled.jpg 1455w\" sizes=\"(max-width: 582px) 100vw, 582px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2.jpg\"><img decoding=\"async\" loading=\"lazy\" width=\"945\" height=\"1024\" src=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-945x1024.jpg\" alt=\"\" class=\"wp-image-31215\" srcset=\"https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-945x1024.jpg 945w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-277x300.jpg 277w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-768x832.jpg 768w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-1418x1536.jpg 1418w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2-1890x2048.jpg 1890w, https:\/\/csccm.org.cn\/wp-content\/uploads\/2026\/06\/nejmoa2602167_t2.jpg 1999w\" sizes=\"(max-width: 945px) 100vw, 945px\" \/><\/a><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">CONCLUSIONS<\/h3>\n\n\n\n<p>In injured patients with hemorrhagic shock, the use of whole blood for prehospital transfusion did not result in lower 30-day mortality than the use of blood components. (Funded by the Defense Health Agency Research Technology Portfolio Management, Combat Casualty Portfolio; TOWAR ClinicalTrials.gov number,&nbsp;<a href=\"https:\/\/clinicaltrials.gov\/show\/NCT04684719\" target=\"_blank\" rel=\"noreferrer noopener\">NCT04684719<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ORIGINAL ARTICLE Prehospital Resuscitation with Type O  [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31209"}],"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=31209"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31209\/revisions"}],"predecessor-version":[{"id":31216,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31209\/revisions\/31216"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}