02707nam a2200301 4500 ESSALUD 20260805094732.0 ta t pe ||||| |||| 00| 0 spa d BMG eng Sperry, Jason L Autor 53909 Prehospital resuscitation with type o whole blood for trauma and hemorrhage páginas: 23017-2328 Background: 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. Methods: 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. Results: 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). Conclusions: 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. NEUMOLOGÍA 25628 CUIDADOS INTENSIVOS 5208 MEDICINA DE URGENCIAS 53820 HEMATOLOGÍA 7422 MEDICINA CLÍNICA 33681 CHOQUE 44162 Guyette, Francis X. 53910 Cotton, Bryan A. 53911 Luther, James F. 53912 Utarnachitt, Richard B. 53913 22717 22640 Massachusetts NEJM Group NEJM007 The New England Journal of Medicine ESSALUD 0028-4793 ARTICULOS 2026-08-03 SQB 22768 22768