• Roman Dudaryk, Aaron S Hess, Albert J Varon, and John R Hess.
• aDivision of Trauma Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida bDepartment of Anesthesia, University of Wisconsin Hospital and Clinics, Madison, Wisconsin cDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
• Curr Opin Anaesthesiol. 2015 Apr 1;28(2):206-9.

Purpose Of ReviewThe aim of the present review was to describe recent changes in blood banking thinking, practice, and products that affect trauma care.Recent FindingsPrompt balanced hemostatic resuscitation of major hemorrhage from trauma improves outcome and reduces blood use. New blood processes and products can help deliver appropriate doses of procoagulant plasma and platelets quicker and more safely. New processes include holding larger inventories of thawed plasma with risk of wastage and rapid plasma thawers. New products in the blood bank include group A or group A low-titer B thawed plasma and AB or A liquid (never-frozen) plasma for resuscitation, prepooled cultured whole blood-derived platelets in plasma, and prepooled cryoprecipitate in varying pool sizes. Single-donor apheresis or pooled whole blood-derived platelets in additive solution, designed to reduce plasma-related transfusion reactions, are also increasingly available but are not an appropriate blood component for hemorrhage control resuscitation because they reduce the total amount of administered plasma coagulation factors by 10%.SummaryEarly initiation of balanced massive transfusion protocols leading to hemostatic resuscitation is lifesaving. Changing blood product availability and composition will lead to higher complexity of massive transfusion. It is critical that anesthesiologists understand the composition of the available new blood products to use them correctly.

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