Transfusion最新文献

{"title":"Low-titer group O whole blood implementation in a tertiary care hospital in Estonia.","authors":"Riin Kullaste, Marika Pikta, Mari Loot, Stanislava Russakova, Eve Laansoo, Kadri Rohtla, Gulara Khanirzajeva, Ene Vadi, Dina Ljahh","doi":"10.1111/trf.18137","DOIUrl":"10.1111/trf.18137","url":null,"abstract":"<p><p>The implementation of the use of low titre group O whole blood in the North Estonia Medical Centre took place in a little more than 2 years. It began with the creation of a low-titer O+ male donor registry, included a pilot project with a limited number of patients, validation of whole blood as a new product, and also required a change in the Estonian law. Today, whole blood is in routine use in emergency patients of both sexes and all ages with life-threatening bleeding. Among the indications, gastro intestinal bleeding comes first, followed by acute blood loss associated with trauma. Whole blood is also included in the massive transfusion protocol.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S237-S239"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide estimates of potential lives saved with prehospital blood transfusions.","authors":"Daniel T Lammers, Richard Betzold, Reynold Henry, Joshua Dilday, Jeffrey R Conner, James M Williams, John M McClellan, Matthew J Eckert, Jan O Jansen, Jeffrey Kerby, John B Holcomb, Zain G Hashmi","doi":"10.1111/trf.18174","DOIUrl":"10.1111/trf.18174","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital blood transfusions result in a significant reduction in mortality risk for injured patients in hemorrhagic shock; however, prehospital blood transfusions have not been widely implemented across the United States. Thus, a paucity of data surrounding the impact of achieving near-complete population-level access to this resource exists. We aimed to determine the number of lives that could potentially have been saved among injured patients in hemorrhagic shock between 2020 and 2023 had prehospital blood products (blood components or whole blood, pBP) been fully implemented.</p><p><strong>Methods: </strong>We performed a retrospective review of the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 for all trauma patients ≥16 years. Patients with prehospital systolic blood pressure <90 mmHg and heart rate >108 beats per minute, or a systolic blood pressure <70 mmHg, and who did not receive pBP products were included in the analysis. Potential lives saved were calculated using mortality and risk ratio estimates (RR) from previously published studies, assuming 100% nationwide access to pBP. A series of models were developed incorporating varying RR, mortality rate assumptions, and nationwide access to pBP to encompass a wide range of scenarios.</p><p><strong>Results: </strong>A total of 260,472 patients met our inclusion criteria. Using a 22.1% 24-h mortality rate and an RR of 0.629, 21,356 deaths over the four-year study period could have potentially been saved with the nationwide implementation of pBP.</p><p><strong>Conclusion: </strong>Transfusion of pBP offers the potential to save thousands of injured patients lives. Efforts toward making policy-level interventions aimed at increasing the adoption and availability of pBP should be sought.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S14-S22"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of prehospital chest decompression in resolving clinical signs of tension pneumothorax.","authors":"Tomer Talmy, Dean Lichter, Cole D Bendor, Irina Radomislensky, Avishai M Tsur, Ofer Almog","doi":"10.1111/trf.18199","DOIUrl":"10.1111/trf.18199","url":null,"abstract":"<p><strong>Background: </strong>Thoracic injuries are a leading cause of morbidity and mortality in military trauma. Tension pneumothorax (TPX) is a critical diagnosis that can lead to rapid hemodynamic and respiratory collapse if untreated. While timely intervention is essential, prehospital TPX diagnosis is challenging and may lead to unnecessary interventions. This study aimed to assess military prehospital chest injury management, including indications for chest decompression and clinical improvement post-intervention.</p><p><strong>Study design and methods: </strong>Retrospective analysis of the Israel Defense Forces (IDF) Trauma Registry from January 2010 to August 2023 identifying patients who underwent needle or chest tube decompression. Data included demographics, injury mechanisms, vital signs, additional interventions, and prehospital mortality. Chart review evaluated decompression indications and outcomes, with the primary outcome being resolution of decreased oxygen saturation, tachycardia, or hypotension post-decompression.</p><p><strong>Results: </strong>Overall, 224 patients were included, with a median age of 22 years. The most common injury mechanisms were gunshots (36.6%) and motor vehicle accidents (34.4%). Needle chest decompression was performed in 58.5% of cases, chest tubes in 12.5%, and both in 29.0%. Indications included traumatic cardiac arrest (53.1%), profound shock (17.9%), and SpO₂ < 85% (13.8%). In 15.2% of cases, decompression did not meet the IDF guideline criteria. Only three cases (1.3%) showed resolution of tachycardia, hypotension, or low oxygen saturation. In five cases, vital signs briefly returned after traumatic cardiac arrest, but none survived to hospital admission.</p><p><strong>Discussion: </strong>Chest decompression may be overutilized in prehospital military trauma. Future studies should refine criteria to optimize benefits while minimizing iatrogenic risks.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S103-S112"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of time to death for children with life-threatening hemorrhage from traumatic, surgical, and medical etiologies.","authors":"Rachel P Vaizer, Christine M Leeper, Liling Lu, Cassandra D Josephson, Julie C Leonard, Mark H Yazer, Joshua B Brown, Philip C Spinella","doi":"10.1111/trf.18144","DOIUrl":"10.1111/trf.18144","url":null,"abstract":"<p><strong>Introduction: </strong>Life-threatening hemorrhage (LTH) is a significant cause of mortality in pediatrics. Timing of mortality in children with LTH is important for future trials.</p><p><strong>Methods: </strong>In a secondary analysis of the prospective observational massive transfusion in children (MATIC) study, time-to-event analysis was performed to determine timing of death based on etiology of LTH and cause of death.</p><p><strong>Results: </strong>There were 449 children with LTH; the etiologies of LTHs included trauma (46%), operative (34%), and medical (20%). The cause of death at 24 h in the trauma group was 56% from hemorrhage and 42% from central nervous system (CNS) failure; in operative group it was 94% from hemorrhage and 6% CNS failure; in medical group it was 84% hemorrhage and 3% CNS failure. The median (interquartile range [IQR]) time to death (hours) varied by cause of death (hemorrhagic: 3.3 [1.0-10.3], CNS failure: 30.4 [9.0-63.6]). For traumatic LTH, 90% of hemorrhage-related deaths occurred within 19 h and 90% of CNS failure deaths occurred within 92 h. For operative LTH, 90% of hemorrhage-related deaths occurred within 5 days and 90% of CNS failure deaths occurred within 28 days. For medical LTH, 90% of hemorrhage-related deaths occurred within 44 h and 90% of CNS failure deaths occurred within 24 days.</p><p><strong>Conclusion: </strong>In children, timing of death differs according to etiology of LTH and by cause of death. The choice of primary outcome for trials in children with LTH should consider these differences based on the etiology of LTH being studied.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S48-S56"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it: An institutional protocol for the management of RhD negative women who receive RhD positive blood.","authors":"Rahaf Alkhateb, Kirea Mazzolini, Vipulkumar Pravinbhai Prajapati, Chantal Harrison, Kayla E Ireland, Donald Jenkins, John Daniels, Leslie Greebon","doi":"10.1111/trf.18181","DOIUrl":"10.1111/trf.18181","url":null,"abstract":"<p><strong>Background: </strong>RhD alloimmunization can result from blood transfusion or fetomaternal hemorrhage (FMH). Preventing alloimmunization in childbearing-age women with FMH via utilization of RhD immunoglobulin (RhIG) is well known; however, there are no established protocols for RhD-mismatched transfusions in emergent or traumatic settings. Here, we describe our hospital protocol for managing RhD negative women who receive RhD positive transfusions.</p><p><strong>Design: </strong>Pathology or Transfusion Medicine staff are notified of RhD-mismatched blood transfusions. Women with childbearing potential are evaluated by Obstetrics and Gynecology (ObGyn) to determine patients' childbearing desires and physical capabilities, as well as their ability to tolerate RhIG administration. Pathologists determine eligibility for therapy with RhIG: criteria include RhD negative females, <50 years old, without current or historical Anti-D, who have been transfused <20% of their total blood volume (TBV) with RhD positive blood.</p><p><strong>Results: </strong>Management strategy depends on red blood cell volume (RBCv) transfused. Patients who receive an RBCv ≤20% of their TBV are eligible to receive RhIG, while an RBCv >20% makes individuals ineligible for prophylaxis with RhIG. Red cell exchange (RCX) is not offered at our institution, regardless of RBCv transfused. Women who receive RhIG should be screened for the development of antibodies using direct and indirect antiglobulin tests for 6-12 months posttransfusion. Future pregnancies of alloimmunized women should be carefully monitored.</p><p><strong>Conclusion: </strong>Our therapeutic plan involves identifying eligible patients based on set criteria. This is the first published protocol to prevent RhD alloimmunization in females of childbearing age due to RhD-mismatched transfusions.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S320-S327"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Freeze-dried plasma: Hemostasis and biophysical analyses for damage control resuscitation.","authors":"Aron A Shoara, Kanwal Singh, Henry T Peng, Katy Moes, Jeong-Ah Yoo, Sahar Sohrabipour, Sanewal Singh, Rex Huang, Peter Andrisani, Chengliang Wu, Katerina Pavenski, Paul Y Kim, Bernardo Trigatti, Colin A Kretz, Ori D Rotstein, Shawn G Rhind, Andrew N Beckett","doi":"10.1111/trf.18124","DOIUrl":"10.1111/trf.18124","url":null,"abstract":"<p><strong>Background: </strong>Effective hemorrhage protocols prioritize immediate hemostatic resuscitation to manage hemorrhagic shock. Prehospital resuscitation using blood products, such as whole blood or alternatively dried plasma in its absence, has the potential to improve outcomes in hemorrhagic shock patients. However, integrating blood products into prehospital care poses substantial logistical challenges due to issues with storage, transport, and administration in field environments.</p><p><strong>Study design and methods: </strong>We utilized hemostatic assays and advanced biophysical techniques, such as calorimetry, infrared spectoscopy, dynamic light scattering, and biolayer interferometry, to compare the functional and structural properties of freeze-dried plasma (FDP; OctaplasLG Powder, Octapharma AB) with those of fresh plasma controls.</p><p><strong>Results: </strong>Hemostatic characterization of FDP revealed that clot formation properties and coagulation parameters were largely comparable to fresh plasma controls, with some variations observed in Von Willebrand factor-ADAMTS13 axis and fibrinolysis. No change to moisture content of FDP (~1% water content) was observed after 6-month storage at ambient conditions. Biophysical analyses of FDP during transfusion demonstrated spontaneous exothermic mixing of FDP in plasma, a dilution effect from saline, as well as comparable stability to plasma controls. Quantification of ligand-binding affinities of platelet receptors activated GPIIbIIIa and GPIbα showed comparable binding properties to plasma controls.</p><p><strong>Conclusion: </strong>Our results show that FDP exhibits hemostatic functionality and protein stability on par with fresh plasma, as assessed by novel, highly sensitive techniques. FDP therefore represents a viable alternative to conventional plasma in damage control resuscitation, offering significant logistical and storage advantages for prehospital and remote applications, especially in scenarios where whole blood is unavailable.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S250-S264"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drawing and storing whole blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle-A proof-of-concept study: Part 2.","authors":"Martin Rognhaug, Hanne Braathen, Håkon Skogrand Eliassen","doi":"10.1111/trf.18200","DOIUrl":"10.1111/trf.18200","url":null,"abstract":"<p><strong>Background: </strong>Disruptions in supply chains during crises and wars necessitate innovative solutions for blood collection. This study evaluates the feasibility and safety of using a 3D-printed bottle cap (BC²L) with a standard 500 mL drinking bottle for whole blood collection as an alternative to traditional systems.</p><p><strong>Study design and method: </strong>We conducted a feasibility study with 20 healthy adult volunteers. Participants were randomized to donate blood into either the BC²L-drinking bottle setup (Test) or a conventional single blood collection bag (control). Blood samples were analyzed for hemolysis, bacterial contamination, and mechanical integrity immediately post-donation, and at 24 and 72 h. Donation time and donor safety were also assessed. Bacterial growth testing and hematological analyses followed sterile procedures to measure hematological quality.</p><p><strong>Results: </strong>Blood collection was completed within a mean time of 7 min across both groups. Hemolysis levels remained below clinically significant thresholds in both setups, and no bacterial contamination was observed. While the BC²L system demonstrated effective blood collection, minor leakage was noted in some bottles during transportation, attributed to the limitations of the 3D-printing process.</p><p><strong>Conclusion: </strong>The BC²L system represents a feasible, low-cost alternative for whole blood collection in resource-limited or crisis settings. It demonstrated comparable safety and mechanical integrity to standard systems. However, manufacturing refinements are needed to address leakage during transport. This study supports the potential of the BC²L as a valuable tool for enhancing medical preparedness in austere environments.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S219-S226"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"War medicine\" The Battle for whole blood: 1943-1945 and beyond.","authors":"Emily Mayhew","doi":"10.1111/trf.18151","DOIUrl":"https://doi.org/10.1111/trf.18151","url":null,"abstract":"<p><p>This article aims to convey two particular statements of historical value for its readers. Firstly, it seeks to remind everyone with an interest in the history of the United States (US) Blood Program that the use of whole blood in the combat casualty care in this great military campaign was by no means certain. Secondly, it hopes to draw the attention of the readers of Transfusion to the very considerable efforts of their professional predecessors to record the process whereby whole blood did, eventually, become the standard of care. Compiled by the Army Historical Unit, the Official History of the US Army Medical Department in World War contains a number of volumes detailing what it summarizes as \"War Medicine.\" This official history devotes an entire volume to the subject of the Blood Program and its development of front line transfusion, as well as including supplementary material in other volumes where transfusion proved to be a crucial component in successful medical provision (such as the volume on Surgery). The editors and contributors had a clear understanding of the fundamental importance of the achievement of the blood program and were determined to reflect this in what would become their definitive work.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":"65 Suppl 1 ","pages":"S1-S3"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential military applications for a new freeze-dried plasma.","authors":"Anthony E Pusateri, Adam J Kishman, Mohamad Azlan Bin Ariffin, Sarah Watts, Emrys Kirkman, Richard B Weiskopf, Brendan S O'Brien, Sandy J Snyder, Sylvain Cardin, Ewell M Hollis, Oliver Hegener","doi":"10.1111/trf.18213","DOIUrl":"10.1111/trf.18213","url":null,"abstract":"<p><p>Hemorrhage is a leading cause of potentially preventable death in both military and civilian trauma. Current resuscitation approaches minimize crystalloids and emphasize plasma and other blood components to achieve a balanced transfusion as early as possible after injury. Owing to the nature of military operations, military medical systems must contend with great distances, degraded infrastructure, and harsh environments, as well as combat and humanitarian assistance and disaster relief (HADR) scenarios. These factors limit both patient movement and the ability to deliver blood products to the point of need. Current projections are that future military scenarios will have longer times to reach a medical treatment facility than experienced in recent conflicts, increasing the need for logistically efficient blood products. Freeze-dried plasma (FDP) is rapidly available, easy to use, and shelf-stable at room temperature, making it easier to deliver at the point of need in challenging military environments. For the past 30 years, FDP has been available in only a few countries. Where it has been available, it has become the preferred plasma for austere or military expeditionary settings. Recently, a new FDP, OctaplasLG Powder, was approved in 17 countries worldwide and for emergency use by the Canadian and United States militaries. It is expected that FDP will soon become available to many more militaries. This review discusses the importance of plasma, reassesses the potential military uses of FDP across the range of military operations, and provides a brief discussion of OctaplasLG Powder.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S240-S249"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic acid is associated with post-injury mortality in a resource-limited trauma system: Findings from the epidemiology and outcomes of prolonged trauma care cohort study.","authors":"Adane F Wogu, Julia M Dixon, Mengli Xiao, Hendrick J Lategan, George Oosthuizen, Steven G Schauer, Elmin Steyn, Smitha Bhaumik, Janette Verster, Craig Wylie, Shaheem de Vries, Mohammad Mayet, Lesley Hodsdon, Leigh Wagner, L' Oreal Snyders, Karlien Doubell, Denise Lourens, Willem Stassen, Christiaan Rees, Jessica Young, Ernest E Moore, Nee-Kofi Mould-Millman","doi":"10.1111/trf.18171","DOIUrl":"10.1111/trf.18171","url":null,"abstract":"<p><strong>Background: </strong>Injury-related deaths claim millions of lives annually, with severe hemorrhage a leading cause. This study assesses tranexamic acid (TXA) administered within 3 h post-injury on mortality in trauma patients.</p><p><strong>Study design and methods: </strong>We conducted secondary database analysis of EpiC, a multicenter, prospective cohort of trauma patients in South Africa. We compared mortality between severely injured patients at risk for traumatic hemorrhage receiving TXA within 3 h post-injury versus untreated patients. Inverse probability of treatment weighting adjusted for confounders, and multivariate logistic regression assessed 24-h mortality, with extended secondary outcome analyses.</p><p><strong>Results: </strong>Of 3607 analyzed patients, 502 received TXA within 3 h. TXA reduced 24-h mortality by 38% (marginal odds ratio [mOR], 0.62; 95% confidence interval [CI], 0.49-0.78) versus untreated patients. Similar reductions were observed for longer-term mortality. Subgroup analyses revealed reduced mortality when TXA was given within 2 h post-injury (mOR, 0.57; 95% CI, 0.45-0.73), doses of 1 g of TXA within 3 h (mOR, 0.73; 95% CI, 0.56-0.94), and those with the highest risk of hemorrhage (mOR, 0.40; 95% CI, 0.30-0.53). The 24-h mortality reduction was significant for patients with penetrating injury (mOR, 0.58; 95% CI, 0.43-0.78) but not for blunt injury patients. Sensitivity analyses confirmed the robustness of these findings, with TXA consistently reducing mortality odds by 28%-39% across subgroups.</p><p><strong>Discussion: </strong>Early TXA administration significantly reduced mortality in trauma patients, especially with penetrating injuries and those with the highest risk of hemorrhage. One-gram dosing was as effective as higher doses, and mortality reduction was notable when TXA was given within 2 h post-injury. These findings support TXA use in resource-limited trauma protocols.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S276-S287"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}