JAMA Pediatr. 2018 May 1;172(5):491-492. doi: 10.1001/jamapediatrics.2017.5238.

# Use of uncrossmatched cold-stored whole blood in injured children with hemorrhagic shock.

Leeper CM, Yazer M, Cladis F, Saladino R, Triulzi D, Gaines B

Hemorrhagic shock is the most common cause of preventable death in pediatric civilian trauma. Balanced resuscitation with blood components has become the standard of care for initial hemostatic resuscitation in adults and children to mitigate the deleterious effects of trauma-induced coagulopathy. Whole blood (WB) contains plasma, red blood cells (RBCs), and platelets and requires less processing and dilution compared with reconstituting WB using components, making it an ideal resuscitative fluid. However, in non–group O recipients, there is a theoretical risk for hemolysis from anti-A and anti-B antibodies in group O WB units. Recently, the transfusion of WB in bleeding adult male trauma patients has been instituted in a large adult trauma center. Whole blood has never been transfused in a pediatric civilian trauma population; the novel use of transfusion of WB in injured children is herein described.