02707nam a2200301   4500001000800000005001700008007000300025008004100028040000800069041000800077100003400085245008000119300002600199520173500225650002401960650003001984650003302014650002402047650003002071650001802101700003202119700002902151700003002180700003702210773011002247942003102357999001702388ESSALUD20260805094732.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aSperry, Jason LeAutor953909  aPrehospital resuscitation with type o whole blood for trauma and hemorrhage  apáginas: 23017-2328  aBackground: 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. 
  aNEUMOLOGÍA925628  aCUIDADOS INTENSIVOS95208  aMEDICINA DE URGENCIAS953820  aHEMATOLOGÍA97422  aMEDICINA CLÍNICA933681  aCHOQUE944162  aGuyette, Francis X. 953910  aCotton, Bryan A. 953911  aLuther, James F.  953912  aUtarnachitt, Richard B.  9539130 022717922640dMassachusetts NEJM GroupoNEJM007tThe New England Journal of Medicine wESSALUDx0028-4793  cARTICULOSe2026-08-03zSQB  c22768d22768