Feasibility assessment for use of Rh-positive blood products during emergency resuscitation in the North Texas trauma population

Abstract

The purpose of this study was to evaluate the extent to which a blood bank policy aimed at decreasing the risk of hemolytic disease of the fetus and newborn (HDFN) by limiting emergency-release blood to Rh-negative blood products is effective. We conducted a retrospective review of the trauma registry for all trauma patients evaluated at our level II trauma center. Patients who received blood products within 4 h of arrival were included. Focused chart review was performed to describe the ABO type, Rh blood type, and sex of the blood recipient in the study population. We identified 262 patients who received emergent transfusion, including 64 women. Four of the 64 women (6%) were Rh negative. Of these, one was of childbearing potential, which represents 0.4% of the 262 patients who received emergency-release blood products and 1.6% of the 64 women emergently transfused following trauma. During our study interval, 1527 units of blood were transfused to patients who could have received Rh-positive blood without concern for HDFN. The proscription against Rh-positive blood as an emergency-release blood product only minimally reduces the risk of development of future HDFN in our trauma population.

Keywords:

• ABO blood group
• emergency transfusion
• hemolytic disease of the fetus and newborn
• low titer whole blood
• Rh blood group
• trauma