000			02707nam a2200301 4500
001			ESSALUD
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040			_aBMG
041			_aeng
100			_aSperry, Jason L _eAutor _953909
245			_aPrehospital resuscitation with type o whole blood for trauma and hemorrhage
300			_apáginas: 23017-2328
520			_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.
650			_aNEUMOLOGÍA _925628
650			_aCUIDADOS INTENSIVOS _95208
650			_aMEDICINA DE URGENCIAS _953820
650			_aHEMATOLOGÍA _97422
650			_aMEDICINA CLÍNICA _933681
650			_aCHOQUE _944162
700			_aGuyette, Francis X. _953910
700			_aCotton, Bryan A. _953911
700			_aLuther, James F. _953912
700			_aUtarnachitt, Richard B. _953913
773	0		_022717 _922640 _dMassachusetts NEJM Group _oNEJM007 _tThe New England Journal of Medicine _wESSALUD _x0028-4793
942			_cARTICULOS _e2026-08-03 _zSQB
999			_c22768 _d22768