08/02/2024
Blood - We know it’s critical, so we must adapt
This article published in Task & Purpose by a who’s who in military medicine makes a compelling case for fielding dried plasma to our military forces.
Here are top line points from the article:
🩸 Hemorrhage is a leading cause of death on the battlefield.
🩸Most hemorrhage deaths occur before the casualty reaches a MTF.
🩸Forward-staged blood products, if available at all, exist in limited quantities, and present logistical challenges.
🩸Dried plasma confers logistical advantages (long shelf life, portability, and temperature stability) over other blood products.
🩸 Dried Plasma (freeze-dried or spray-dried) can temporarily stabilize casualties who require blood transfusion.
🩸FDA approval of Dried Plasma has been pending since 2008.
🩸WWII and Korean War casualties benefitted from Dried Plasma.
🩸Plasma use was stopped due to concerns about hepatitis, yet today’s risk of hepatitis from plasma transfusion is less than 1 in 100,000 units.
🩸 France, Israel, Germany, and South Africa use freeze-dried plasma routinely.
🩸 A study demonstrated that plasma transfused shortly after injury en route to the hospital resulted in a 30% reduction in death compared to no plasma, particularly with long transport time.
🩸Blood demand exceeds whole blood supply. It is expected that 20% of WIA will require blood product therapy (1600 units/day in LSCO).
🩸Walking Blood Banks are a good contingency plan but there are risks in LSCO that: 1) the environment might be too kinetic to execute the WBB safely; 2) casualty numbers may exceed the blood available from WBBs; and 3) obtaining blood regularly from l warfighters may reduce combat end-strength due to decreased function among donors.
🩸Whole blood is temperature sensitive and has a short shelf life.
To save lives on future battlefields, the DoD must continue to push for Dried Plasma fielding and continue to fund high quality research studies to compare transfusion strategy outcomes.
On day one of LSCO, to be truly ready to manage the large volume of anticipated casualties – the US military should have tens of thousands of Dried Plasma units in its armamentarium to save lives on the battlefield.
Article 🔗 https://taskandpurpose.com/opinion/dried-plasma/
Journal of Special Operations Medicine NATO Centre of Excellence for Military Medicine U.S. Army Medical Center of Excellence
