The Return to LT-O-Whole Blood (LTOWB) for OB Transfusion

Dr. Chapa’s Clinical Pearls.

Prior to the 1970s, when component therapy became the preferred method of resuscitation, whole blood (WB) was the resuscitative medium of choice for hemorrhagic shock. In modern medicine, sometimes it turns out that the old way is better than the new…and using whole blood for transfusions is one example. Research is emerging that shows whole blood works better for these patients than fractionated components of blood. Beginning in 2017, multiple stakeholders within the Southwest Texas Regional Advisory Council for Trauma- as well as others in different states, collaborated to incorporate cold-stored low-titer O RhD-positive whole blood into all phases of their trauma system, including the prehospital care via EMS. Although the program was initially focused on trauma resuscitation, it was expanded to include non-traumatic hemorrhagic shock patients that may benefit from whole blood resuscitation when MTP is needed. What about Low Titer O Pos whole blood use for maternal MTP resuscitation? Is there data there? And what about the risk with using type O whole blood as a donor. In this episode, we’ll dive into the details.