Coagulation Function of Stored Whole Blood is Preserved for 14 Days in Austere Conditions: A ROTEM Feasibility Study During a Norwegian Antipiracy Mission and Comparison to Equal Ratio Reconstituted Blood

Abstract

Formulation of a medical preparedness plan for treating severely bleeding casualties during naval deployment is a significant challenge because of territory covered during most missions. The aim of this study was to evaluate the concept of walking blood bank as a supportable plan for supplying safe blood and blood products. In 2013, the Royal Norwegian Navy conducted antipiracy operations from a frigate, beginning in the Gulf of Aden and ending in the Indian Ocean. Crews were on 24-hour emergency alert in preparation for an enemy assault on the frigate. Under an approved command protocol, a walking blood bank, using crew blood donations, was established for use on board and on missions conducted in rigid-hulled inflatable boats, during which freeze-dried plasma and leukoreduced, group O low anti-A/ anti-B titer, cold-stored whole blood were stored in Golden Hour Boxes. Data demonstrating the ability to collect, store, and provide whole blood were collected to establish feasibility of implementing a whole blood Y focused remote damage-control resuscitation program aboard a naval vessel. In addition, ROTEM data were collected to demonstrate feasibility of performing this analysis on a large naval vessel and to also measure hemostatic efficacy of cold-stored leukoreduced whole blood (CWB) stored during a period of 14 days. ROTEM data on CWB was compared with reconstituted whole blood. Drills simulating massive transfusion activation were conducted, in which 2 U of warm fresh whole blood with platelet sparing leukoreduction were produced in 40 minutes, followed by collection of two additional units at 15-minute increments. The ROTEM machine performed well during ship-rolling, as shown by the overlapping calculated and measured mechanical piston movements measured by the ROTEM device.

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Document Details

Document Type
Technical Report
Publication Date
Jun 24, 2015
Accession Number
ADA620456

Entities

People

  • Andrew P Cap
  • Einar K. Kristoffersen
  • Geir Strandenes
  • Heather Pidcoke
  • Ivar Austlid
  • Jan Sommerfelt-pettersen
  • Maryanne C. Herzig
  • Tor A. Hervig
  • Torunn O. Apelseth

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Blood
  • Blood Banks
  • Blood Cells
  • Blood Coagulation Factors
  • Blood Groups
  • Blood Transfusions
  • Data Analysis
  • Deployment
  • Feasibility Studies
  • Health Care
  • Health Services
  • Hospitals
  • Information Science
  • Medical Personnel
  • Military Personnel
  • Naval Vessels
  • Statistical Analysis

Readers

  • Maritime Security/Maritime Homeland Security
  • Trauma Surgery or Emergency Medicine.