Nouh Thamer, Shalhoub Mishary, Alburakan Ahmed, Alshahwan Nawaf, Alzelfawi Lama, Almajed Ebtesam, Alhindawi Zeena, Bin Salamah Rawan, AlMutiri Wijdan, Alruwaili Ebtisam, Alhawas Abdulelah, Almutairi Nourah, Mashbari Hassan
Trauma and Acute Care Department, King Saud University, Riyadh 12271, Saudi Arabia.
Trauma and Acute Care Department, King Abdullah Bin Abdulaziz University Hospital, Riyadh 11564, Saudi Arabia.
J Clin Med. 2024 Aug 12;13(16):4726. doi: 10.3390/jcm13164726.
Whole blood is a product that contains all three blood components (plasma, red blood cells, and platelets). This systemic review and meta-analysis was conducted to identify barriers and obstacles to establishing whole blood transfusion protocols in civilian hospitals. The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42024519898. Traumatic patients who needed or received whole blood transfusion were included. A systematic literature review employed a comprehensive search strategy through the PubMed, Google Scholar, Web of Science, ScienceDirect, and ProQuest databases. Meta-analysis was utilized to analyze the outcomes. The risk of bias was assessed using the Newcastle-Ottawa Scale. In total, 310 studies were identified, and 11 studies met the inclusion criteria. The following intervals were used to assess the prevalence of mortality: 6 h 12.15% (0.081, 95% CI [0.023, 0.139]), 24 h 14.08% (0.141, 95% CI [0.111, 0.171]), delayed mortality (28-30 days) 22.89% (0.284, 95% CI [0.207, 0.360]), and in-hospital 18.72%, with relative risk (0.176, 95% CI [0.114,0.238]). Traumatic patients can be effectively resuscitated and stabilized with whole blood transfusion (WBT), but it is essential to provide ongoing critical care, address logistical challenges, and prevent blood product wastage. We recommend utilizing WBT in the early stages of resuscitation for adult civilian trauma patients.
全血是一种包含所有三种血液成分（血浆、红细胞和血小板）的产品。本系统评价和荟萃分析旨在确定在 civilian 医院建立全血输血方案的障碍和阻碍。该研究按照 PRISMA 指南进行，PROSPERO 注册号为 CRD42024519898。纳入了需要或接受全血输血的创伤患者。系统文献回顾通过 PubMed、谷歌学术、科学网、ScienceDirect 和 ProQuest 数据库采用全面的检索策略。利用荟萃分析来分析结果。使用纽卡斯尔-渥太华量表评估偏倚风险。总共识别出 310 项研究，11 项研究符合纳入标准。使用以下时间段来评估死亡率：6 小时为 12.15%（0.081，95%置信区间[0.023，0.139]），24 小时为 14.08%（0.141，95%置信区间[0.111，0.171]），延迟死亡率（28 - 30 天）为 22.89%（0.284，95%置信区间[0.207，0.360]），住院期间为 18.72%，相对风险为（0.176，95%置信区间[0.114，0.238]）。创伤患者通过全血输血（WBT）可以得到有效复苏和稳定，但持续提供重症监护、解决后勤挑战以及防止血液制品浪费至关重要。我们建议在成年 civilian 创伤患者复苏的早期阶段使用 WBT。
