Prehospital Whole Blood in Traumatic Hemorrhage - A Randomized Controlled Trial.
The New England journal of medicine, 2026 · Pragmatic multicenter open-label randomized superiority trial
What the trial found
48.7% versus 47.7%; RR 1.02 (95% CI 0.80–1.31), P=.84.
Clinical interpretation
No superiority; limited prehospital regimen and analysis population do not establish equivalence for every in-hospital MTP.
The trauma lethal diamond (hypothermia, acidosis, coagulopathy, hypocalcemia), 1:1:1 massive transfusion (PROPPR trial), early TXA (CRASH-2), and TEG/ROTEM algorithms.
Patient-specific RBC transfusion thresholds, current platelet/procedural thresholds, plasma/cryoprecipitate use, and the TRALI vs TACO diagnostic matrix.