{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:30:47Z","timestamp":1790289047279,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T00:00:00Z","timestamp":1567728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Astronauts on exploration missions may be at risk for traumatic injury and medical conditions that lead to life threatening hemorrhage. Resuscitation protocols are limited by the austere conditions of spaceflight. Solutions may be found in low\u2010resource terrestrial settings. The existing literature on alternative blood product administration and walking blood banks was evaluated for applicability to spaceflight.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>A literature review was done using PubMed and Google Scholar. References were crosschecked for additional publications not identified using the initial search terms. Twenty\u2010seven articles were identified, including three controlled trials, six retrospective cohort analyses, 15 reviews, one case report, and two experimental studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Solutions to blood transfusion in austere settings include lyophilized blood products, hemoglobin\u2010based oxygen carriers (HBOCs), and fresh whole blood. Many of these products are investigational. Protocols for walking blood banks include methods for screening and activating donors, transfusion, and monitoring for adverse reactions. Microgravity and mission limitations create additional challenges for transfusion, including baseline physiologic changes, difficulty reconstituting lyophilized products, risk of air emboli during transfusion, equipment constraints, and limited evacuation and surgical options.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Medical planning for space exploration should consider the possibility of acute blood loss. A model for \u201cfloating\u201d blood banks based on terrestrial walking blood bank protocols from austere environments is presented, with suggestions for future development. Constraints on volume, mass, storage, and crew, present challenges to blood transfusion in space and must be weighed against the benefits of expanding medical capabilities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15493","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T13:35:55Z","timestamp":1567776955000},"page":"3077-3083","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Blood transfusion for deep space exploration"],"prefix":"10.1111","volume":"59","author":[{"given":"Elizabeth S.","family":"Nowak","sequence":"first","affiliation":[{"name":"MetroHealth Medical Center Case Western Reserve University School of Medicine  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6672-7910","authenticated-orcid":false,"given":"David P.","family":"Reyes","sequence":"additional","affiliation":[{"name":"Aerospace Medicine, Department of Preventive Medicine and Community Health University of Texas Medical Branch  Galveston Texas"},{"name":"Exploration Medical Capability Johnson Space Center, NASA  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Transfusion Medicine, Department of Pathology University of Texas Medical Branch  Galveston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Cap","sequence":"additional","affiliation":[{"name":"Coagulation and Blood Research Department US Army Institute of Surgical Research  Fort Sam Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric L.","family":"Kerstman","sequence":"additional","affiliation":[{"name":"Aerospace Medicine, Department of Preventive Medicine and Community Health University of Texas Medical Branch  Galveston Texas"},{"name":"Exploration Medical Capability Johnson Space Center, NASA  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik L.","family":"Antonsen","sequence":"additional","affiliation":[{"name":"Exploration Medical Capability Johnson Space Center, NASA  Houston Texas"},{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas"},{"name":"Center for Space Medicine Baylor College of Medicine  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200101000-00036"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.08.028"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2005.02.010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000114"},{"key":"e_1_2_6_6_1","volume-title":"Final Report for Intravenous Fluid Generation(IVGEN) Spaceflight Experiment, Glenn Research Center","author":"McQuillen JB","year":"2011"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31819d85fb"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13929"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13580"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2009.01.002"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13923"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000150"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000842"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02818.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000222671.84335.64"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.150392"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12044"},{"key":"e_1_2_6_18_1","unstructured":"WilliamsS.(2016). 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