Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during operation Iraqi freedom at a U.S. combat support hospital

Philip C. Spinella, Jeremy G. Perkins, Kurt W. Grathwohl, Thomas Repine, Alec C. Beekley, James Sebesta, Donald Jenkins, Kenneth Azarow, John B. Holcomb, Jack Chiles, Lorne Blackbourne, Dennis Nichols, Jennifer Greco, Cynthia Clagett, Gregory Thibault

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. Methods: This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Results: Eighty-seven patients received 545 units of FWB. Upon admission, the average (±S.D.) heart rate was 144 bpm (±25); systolic blood pressure, 106 mmHg (±33); base deficit, 9 (±6.5); hemoglobin, 9.0 g/dl (±2.6); platelet concentration, 81.9 × 10 3/mm3 (±81); international normalized ratio (INR), 2.0 (±1.1); and temperature 95.7°F (±2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6%); foreign nationals, 25/347 (7.2%); and enemy combatants, 11/128 (8.5% (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Conclusions: Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.

Original languageEnglish (US)
Pages (from-to)2-6
Number of pages5
JournalWorld Journal of Surgery
Volume32
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

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2003-2011 Iraq War
Blood Transfusion
Military Personnel
Vital Signs
Wounds and Injuries
Military Facilities
Blood Pressure
Iraq
International Normalized Ratio
Hemorrhagic Shock
Critical Care

ASJC Scopus subject areas

  • Surgery

Cite this

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during operation Iraqi freedom at a U.S. combat support hospital. / Spinella, Philip C.; Perkins, Jeremy G.; Grathwohl, Kurt W.; Repine, Thomas; Beekley, Alec C.; Sebesta, James; Jenkins, Donald; Azarow, Kenneth; Holcomb, John B.; Chiles, Jack; Blackbourne, Lorne; Nichols, Dennis; Greco, Jennifer; Clagett, Cynthia; Thibault, Gregory.

In: World Journal of Surgery, Vol. 32, No. 1, 01.2008, p. 2-6.

Research output: Contribution to journalArticle

Spinella, PC, Perkins, JG, Grathwohl, KW, Repine, T, Beekley, AC, Sebesta, J, Jenkins, D, Azarow, K, Holcomb, JB, Chiles, J, Blackbourne, L, Nichols, D, Greco, J, Clagett, C & Thibault, G 2008, 'Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during operation Iraqi freedom at a U.S. combat support hospital', World Journal of Surgery, vol. 32, no. 1, pp. 2-6. https://doi.org/10.1007/s00268-007-9201-5
Spinella, Philip C. ; Perkins, Jeremy G. ; Grathwohl, Kurt W. ; Repine, Thomas ; Beekley, Alec C. ; Sebesta, James ; Jenkins, Donald ; Azarow, Kenneth ; Holcomb, John B. ; Chiles, Jack ; Blackbourne, Lorne ; Nichols, Dennis ; Greco, Jennifer ; Clagett, Cynthia ; Thibault, Gregory. / Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during operation Iraqi freedom at a U.S. combat support hospital. In: World Journal of Surgery. 2008 ; Vol. 32, No. 1. pp. 2-6.
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abstract = "Background: United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. Methods: This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Results: Eighty-seven patients received 545 units of FWB. Upon admission, the average (±S.D.) heart rate was 144 bpm (±25); systolic blood pressure, 106 mmHg (±33); base deficit, 9 (±6.5); hemoglobin, 9.0 g/dl (±2.6); platelet concentration, 81.9 × 10 3/mm3 (±81); international normalized ratio (INR), 2.0 (±1.1); and temperature 95.7°F (±2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6{\%}); foreign nationals, 25/347 (7.2{\%}); and enemy combatants, 11/128 (8.5{\%} (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Conclusions: Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.",
author = "Spinella, {Philip C.} and Perkins, {Jeremy G.} and Grathwohl, {Kurt W.} and Thomas Repine and Beekley, {Alec C.} and James Sebesta and Donald Jenkins and Kenneth Azarow and Holcomb, {John B.} and Jack Chiles and Lorne Blackbourne and Dennis Nichols and Jennifer Greco and Cynthia Clagett and Gregory Thibault",
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AU - Spinella, Philip C.

AU - Perkins, Jeremy G.

AU - Grathwohl, Kurt W.

AU - Repine, Thomas

AU - Beekley, Alec C.

AU - Sebesta, James

AU - Jenkins, Donald

AU - Azarow, Kenneth

AU - Holcomb, John B.

AU - Chiles, Jack

AU - Blackbourne, Lorne

AU - Nichols, Dennis

AU - Greco, Jennifer

AU - Clagett, Cynthia

AU - Thibault, Gregory

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N2 - Background: United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. Methods: This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Results: Eighty-seven patients received 545 units of FWB. Upon admission, the average (±S.D.) heart rate was 144 bpm (±25); systolic blood pressure, 106 mmHg (±33); base deficit, 9 (±6.5); hemoglobin, 9.0 g/dl (±2.6); platelet concentration, 81.9 × 10 3/mm3 (±81); international normalized ratio (INR), 2.0 (±1.1); and temperature 95.7°F (±2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6%); foreign nationals, 25/347 (7.2%); and enemy combatants, 11/128 (8.5% (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Conclusions: Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.

AB - Background: United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. Methods: This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Results: Eighty-seven patients received 545 units of FWB. Upon admission, the average (±S.D.) heart rate was 144 bpm (±25); systolic blood pressure, 106 mmHg (±33); base deficit, 9 (±6.5); hemoglobin, 9.0 g/dl (±2.6); platelet concentration, 81.9 × 10 3/mm3 (±81); international normalized ratio (INR), 2.0 (±1.1); and temperature 95.7°F (±2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6%); foreign nationals, 25/347 (7.2%); and enemy combatants, 11/128 (8.5% (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Conclusions: Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.

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