Is the Whole Greater Than the Sum of Its Parts? The Implementation and Outcomes of a Whole Blood Program in Ecuador

LATEST ARTICLES
SEARCH INDEX
SUGGEST ARTICLE
THE OSI COLLECTIONS
AUDIOGRAM SERIES
ABOUT THE OSI
2020 SUMMARY

OSI STATISTICS

Open access articles:
768
Annotations added:
3
Countries represented:
102
No. of contributors:
12
Bookmarks made:
21

Is the Whole Greater Than the Sum of Its Parts? The Implementation and Outcomes of a Whole Blood Program in Ecuador


JournalBMC Emergency Medicine
Publication date – Sep – 2020
Authors – Amber Nicole Himmler, Monica Eulalia Galarza Armijos, Jeovanni Reinoso Naranjo, Sandra Gioconda Peña Patiño, Doris Sarmiento Altamirano, Nube Flores Lazo, Raúl Pino Andrade, Hernán Sacoto Aguilar, Lenin Fernández de Córdova, Cecibel Cevallos Agurto, Nakul Raykar, Juan Carlos Puyana, Juan Carlos Salamea Molina
Keywordsdamage control resuscitation, global surgery, hemorrhage, shock, trauma, whole blood
Open access – Yes
SpecialityEmergency surgery
World region South America
Country: Ecuador
Language – English
Submitted to the One Surgery Index on October 20, 2020 at 2:07 am
Abstract:

Background: Hemorrhagic shock is a major cause of mortality in low-and-middle-income countries (LMICs). Many institutions in LMICs lack the resources to adequately prescribe balanced resuscitation. This study aims to describe the implementation of a whole blood program in Latin America and discuss the outcomes of the patients that received whole blood (WB).

Methods: We conducted a retrospective review of patients resuscitated with WB from 2013-2019. Five units of O+ WB were made available on a consistent basis for patients presenting in hemorrhagic shock. Variables collected included: sex, age, service treating the patient, units of WB administered, units of components administered, admission vital signs, admission hemoglobin, Shock Index, intraoperative crystalloid and colloid administration, symptoms of transfusion reaction, length-of-stay and in-hospital mortality.

Results: The sample includes a total of 101 patients, 57 of whom were trauma and acute care surgery (TACS) patients and 44 of whom were obstetrics and gynecology patients. No patients developed symptoms consistent with a transfusion reaction. Average shock index was 1.16 (±0.55). On average, patients received 1.66 (±0.80) units of whole blood. Overall mortality was 14/101 (13.86%) in the first 24 hours and 6/101 (5.94%) after 24 hours.

Conclusion: Implementing a WB protocol is achievable in LMICs. Whole blood allows for more efficient delivery of hemostatic resuscitation and is ideal for resource-restrained settings. To our knowledge, this is the first description of a whole blood program implemented in a civilian hospital in Latin America.

OSI Number – 20683

Public annotations on this article:
No public annotations yet