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Prehospital whole blood no better than components

Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage
New England Journal of Medicine · Added 18 May 2026

Multicenter randomized trial comparing prehospital type O whole blood resuscitation to standard care in trauma patients with hemorrhage.

Study type

RCT

Design

Pragmatic multicentre cluster-randomised phase 3 trial with 1-month blocks

Participants

993 trauma patients with haemorrhagic shock transported by 44 air medical bases (695 whole blood, 298 components)

Main finding

30-day mortality 25.9% with whole blood vs 20.5% with blood components (adjusted OR 1.24, 95% CI 0.87–1.76; P=0.24). No difference by whole blood storage age (15–21 days vs 1–14 days: adjusted OR 0.99, 95% CI 0.74–1.32).

Caveat

Cluster-randomised design with unbalanced group sizes (715 vs 305 patients) may have reduced power; air medical US setting.

Bottom line

Supports current practice

Learning goal

Weigh the benefits and limitations of prehospital whole blood compared with component therapy in traumatic haemorrhagic shock.

More

• Topic: Trauma
• Daily scan: 18 May 2026

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