Dr. Katrina Morgan "Whole Blood Meta-analysis and Parent Perceptions of Transfusing RhD+ Whole Blood in Injured Children" and Jennifer Darby "Conceptual Model of Exercise Training’s Protective Effect against Hemorrhagic Shock+Trauma'"

Presenters: Drs. Katrina Morgan and Jennifer Darby

Dr. Katrina Morgan, MD

Whole Blood Meta-analysis and Parent Perceptions of Transfusing RhD-Positive Whole Blood in Injured Children

In a systematic review and meta-analysis including 15 studies,  LTOWB was associated with improved 24-hour survival (relative risk (RR): 1.07, 95% confidence interval (CI): 1.01-1.13) compared to component therapy, while late survival was not associated with a survival benefit (RR: 1.04, 95% CI: 0.99-1.1). The findings of this meta-analysis suggest upfront LTOWB improves early survival outcomes in bleeding trauma patients compared to component therapy. 

RhD-negative blood products are in chronic short supply leading to renewed interest in using RhD-positive blood for emergency transfusions. This study assessed parental perceptions of emergency RhD-positive blood use in children. A survey on the tolerance of the D-alloimmunization risk on the part of parents/guardians of their daughters £17 years old was conducted at four level 1 pediatric hospitals. In total, 378/409 (92%) respondents completed the assessment of risk tolerance and were included in the analysis. When the risk of harm to a future fetus was given as 0-6%, more than 80% of respondents indicated they were likely to accept RhD-mismatched blood transfusions on behalf of their daughter in a life-threatening situation. The rate of willingness to accept emergent RhD-mismatched blood transfusions significantly increased as the potential survival benefit of the transfusion increased. Further discussions and evidence-based guidelines on transfusing RhD-positive blood products to RhD-unknown females in emergency settings are needed.

Mentor: Dr. Leeper, MD MS

Dr. Jennifer Darby, MD

Establishing a Hypothesized Conceptual Model of Exercise Training’s Protective Effect against Hemorrhagic Shock + Trauma 

Previously, I have reported results demonstrating that the immunometabolic alterations occurring from exercise training are protective against organ injury from hemorrhagic shock and trauma. For this update, I have used insights from our work thus far to probe the literature in an attempt to build a hypothesized conceptual model connecting the immune activation and metabolic adaptation in exercising training and trauma. This conceptual model will be used to design future hypothesis-testing experiments.

Mentor: Dr. Billiar, MD