{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:22:18Z","timestamp":1792819338720,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early resuscitation is based on platelet\u2010poor components such as red blood cells and plasma (RBC\u2009+\u2009P), contributing to platelet dilution and worsening of trauma\u2010induced coagulopathy (TIC). We aimed to compare the ability of cold\u2010stored whole blood (WB) versus RBC\u2009+\u2009P as a single component to correct TIC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Blood samples were collected on admission from trauma patients who required activation of the major hemorrhage protocol at a single UK major trauma center in 2021\/2022. Samples were spiked ex vivo with volumes equivalent to two, four, or eight units of WB or RBC\u2009+\u2009P stored for a maximum of 2\u2009weeks. Thromboelastometry, platelet counting, and multiple electrode aggregometry (MEA) were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Samples from 20 adult trauma patients were analyzed. Median age was 32\u2009years (27\u201342), 89% were male, 70% had platelet dysfunction (tissue factor\u2013activated ROTEM [EXTEM]\u2013tissue factor\u2013activated ROTEM with cytochalasin D [FIBTEM] clot amplitude at 5\u2009min [A5]\u2009\u2264\u200930\u2009mm), 65% were coagulopathic (EXTEM A5\u2009\u2264\u200940\u2009mm), and 42% died. EXTEM\u2013FIBTEM A5 was higher following spiking with WB than RBC\u2009+\u2009P (33\u2009mm, 26\u201333, vs. 27\u2009mm, 24\u201330, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). WB\u2010spiking corrected platelet dysfunction in 2 patient samples out of 20, whereas RBC\u2009+\u2009P increased the frequency of platelet dysfunction (1\/20 sample) and TIC (4\/20 samples). RBC\u2009+\u2009P was associated with a dose\u2010dependent deterioration in rotational thromboelastometry (ROTEM) clot strength and dynamics, platelet count, and aggregation in response to multiple agonists compared with WB\u2010spiking, which maintained or partially corrected these abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with RBC\u2009+\u2009P, WB better preserves ex vivo platelet\u2010related ROTEM parameters, platelet count, and aggregation, but does not fully correct these common derangements of TIC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.18143","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T13:19:21Z","timestamp":1738761561000},"page":"624-636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of whole blood versus red blood cells and plasma to correct trauma\u2010induced coagulopathy ex vivo"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-8351","authenticated-orcid":false,"given":"Andrea","family":"Rossetto","sequence":"first","affiliation":[{"name":"Centre for Trauma Sciences, Blizard Institute Queen Mary University of London  London UK"},{"name":"Barts Health National Health Service Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Vulliamy","sequence":"additional","affiliation":[{"name":"Centre for Trauma Sciences, Blizard Institute Queen Mary University of London  London UK"},{"name":"Barts Health National Health Service Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-554X","authenticated-orcid":false,"given":"Sian","family":"Huish","sequence":"additional","affiliation":[{"name":"Component Development Laboratory National Health Service Blood and Transplant  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Cardigan","sequence":"additional","affiliation":[{"name":"Component Development Laboratory National Health Service Blood and Transplant  Cambridge UK"},{"name":"Department of Haematology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Green","sequence":"additional","affiliation":[{"name":"Centre for Trauma Sciences, Blizard Institute Queen Mary University of London  London UK"},{"name":"Barts Health National Health Service Trust  London UK"},{"name":"Transfusion Medicine National Health Service Blood and Transplant  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Davenport","sequence":"additional","affiliation":[{"name":"Centre for Trauma Sciences, Blizard Institute Queen Mary University of London  London UK"},{"name":"Barts Health National Health Service Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003657"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04327-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018017699"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-03928-y"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3584-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1994.tb01652.x"},{"key":"e_1_2_11_8_1","first-page":"10","article-title":"Extracellular fluid volume replacement in hemorrhagic shock","volume":"14","author":"Carrico C","year":"1963","journal-title":"Surg Forum"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)37537-5"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13239-015-0237-7"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.161664"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12"},{"key":"e_1_2_11_13_1","volume-title":"Transfusion strategies in the pre\u2010hospital setting: evaluating the logistical benefits of pre\u2010hospital whole blood transfusion, and a national survey of pre\u2010hospital blood transfusion","author":"Tucker H","year":"2021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04279-4"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003427"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002799"},{"key":"e_1_2_11_17_1","unstructured":"ISRCTN Registry.SWIFT: study of whole blood in frontline trauma [Internet]. 2022 [cited 2023 Aug 6]. 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