Transfusions may be in the form of whole blood (WB) or blood components (BC). Blood components include red blood cells, platelets, plasma, and cryoprecipitate. Recently, studies have suggested that bleeding cardiac surgery and trauma patients may benefit from WB transfusions. However, storing WB solely for these patients could result in increased blood wastage. Few studies have examined whether WB is also safe for bleeding hospital inpatients. To this end, Geneen et al. performed a rapid systemic review and meta-analysis of randomized controlled trials (RCTs) published between 1975 and 2021 examining 24-hour and 30-day mortality after WB or BC transfusion. After screening 1821 publications, most trials were excluded because they did not report any pre-specified outcomes for the meta-analysis. Six RCTs were included—one trial included trauma patients and five assessed bleeding in non-trauma surgery patients. Based on very-low certainty evidence, no difference in mortality at 24-hour or 30-day was found between patients transfused with WB or BC. Very-low quality evidence suggested that WB may reduce oxygen dependence and hospital stay in non-trauma patients. Further research is needed to confirm these results.
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