Combat medics could have a revolutionary new tool for saving lives if a recently-announced military research program is successful. Late last month, the Defense Advanced Research Projects Agency announced it had selected a team of experts to combine artificial blood, platelets and plasma into a single “whole blood equivalent” that service members and civilians will hopefully be able to use to keep patients alive in an isolated environment or when the genuine article is in short supply.

The four-year, $46.4 million research project is administered by DARPA, though the research itself will be conducted through a collaboration between more than a dozen biotech companies and universities. If it leads to a safe and effective product, it could be a major step forward for emergency medicine.

“About 20,000 Americans each year bleed to death before they can be brought to the hospital,” said Dr. Mark Gladwin, dean of the University of Maryland School of Medicine, in a press release about the research project. “Transfusion at the point of injury is required to stabilize them and limit other organ injury.” 

United States photo

Bleeding is the most common cause of potentially survivable death in trauma in both military and civilian settings, wrote the University of Maryland. Whole blood transfusions can save a patient’s life, but that blood has to come from donors, it requires cold storage, and it has a shelf life of around 40 days. If scientists develop an artificial blood product that lasts a long time and can be moved easily to the point of injury, it could be a game-changer.

“We have assembled an outstanding team to develop a bio-synthetic whole-blood product that can be freeze-dried for easy portability, storage and reconstitution,” said Dr. Allan Doctor, a professor at the University of Maryland School of Medicine who is the principal investigator for the study. “It will be designed for easy use in the field by medics at the point of injury, and will perform like a traditional blood transfusion to, for example, stabilize a patient’s blood pressure or facilitate blood clotting.”

That kind of technology could be a godsend for military medics such as Air Force pararescuemen, who are trained to provide life-saving first aid to the injured, oftentimes while under fire. That is, if the concept of fake blood does not freak anyone out too much.

“First off, it sounds scary as shit!” retired Chief Master Sgt. Ivan Ruiz, a former Air Force pararescueman who received the Air Force Cross and served throughout the Global War on Terror, told Task & Purpose.

“But if it works and doesn’t cause cancer, it would depend on the size and weight of the package and the mission being supported,” Ruiz added. “If everything was ideal, absolutely I would carry it if it could save a life.”

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Blood transfusion has saved soldiers’ lives since at least World War I, but viable supplies of blood can be difficult to find on the battlefield itself. During a firefight in Afghanistan in 2019, after running through the supply of whole blood units they had brought with them, a pair of Army Ranger medics pulled blood from their fellow soldiers in order to treat injured Rangers. The procedure lasted about 10 minutes, much faster than the average 36 minutes it takes for a medevac to arrive, according to the Marine Corps.

U.S. Air Force Pararescuemen from the 38th Rescue Squadron treat patients during a Mass Casualty Full Mission Profile exercise at Moody Air Force Base, Georgia, Jan. 19, 2023. (Airman 1st Class Courtney Sebastianelli/U.S. Air Force).
U.S. Air Force Pararescuemen from the 38th Rescue Squadron treat patients during a Mass Casualty Full Mission Profile exercise at Moody Air Force Base, Georgia, Jan. 19, 2023. (Airman 1st Class Courtney Sebastianelli/U.S. Air Force)

It could take even longer for a medevac to arrive in a possible conflict with China, where experts fear U.S. troops will not enjoy the same air superiority they had during the Global War on Terror. Scientists hope the artificial blood would give troops in that scenario a greater chance at survival.

“It’s not designed to replace blood where blood is available, but to make blood therapy or transfusion therapy available where blood is not an option,” Doctor said in a University of Maryland video on Monday. 

Donated human blood requires cold storage, but scientists hope to design artificial whole blood so that it can be stored at room temperature. That way, it will be more available for military or civilian medics in the field, where heat or air conditioning is not always an option. 

As it turns out, artificial red blood cells, platelets and plasma have already been developed. Now it’s just a matter of combining those products “to create a safe and effective freeze-dried blood product,” according to the University of Maryland video.

“Medics can carry this in an ambulance … for months. And then the moment they need it, they reach for the bag and the expectation is that we would be twisting it to shake it up and release some water,” Doctor explained in the video. “It would mix and they would hang it right away and so they would be able to give a transfusion even inside a car before somebody was even extracted.”

blood transfusion
U.S. Army Sgt. James Wright, a medic assigned to 1st Squadron, 4th Cavalry Regiment, 1st Armored Brigade Combat Team, 1st Infantry Division prepares a blood bag during a blood transfusion training at Trzebien, Poland, April 14, 2022. (Spc. Hassani Ribera/U.S. Army National Guard)

That kind of product could also come in handy during a natural disaster, which might knock out the power systems that keep blood banks refrigerated. Navy corpsmen prepared for such an occasion last year during the exercise Bloodnado 2022. Though that exercise involved packing up the blood bank and moving it somewhere with power, a room temperature artificial blood product might make such movement unnecessary.

The artificial blood study will be conducted using machine learning software and advanced simulations in order to test the prototype in computer-based scenarios. The goal of the first phase of the study is to examine how the prototype can deliver oxygen, stop bleeding and replace lost volume of blood, which the University of Maryland described as the “key therapeutic functions of whole blood in resuscitation.”

The goal of the second phase of the study is to evaluate the safety and efficacy of the prototype “in increasingly complex and realistic trauma models,” the press release said.

The University of Maryland press release pointed out that Doctor co-founded KaloCyte, the company that produces ErythroMer, the artificial blood product that will be tested in the study. Doctor’s interest in the company “has been reviewed in accordance with the university’s conflicts of interest policy to ensure objectivity in the research,” the press release said.

“This project will utilize cutting-edge technologies like artificial intelligence to predict interactions among the blood components in various trauma model systems, which would not have been possible a decade ago,” said Gladwin.

Though the blood may be artificial, the benefits of a technology like this would be very real. Let’s just hope they don’t call it “True Blood.”

Special thanks to The Merge newsletter where we first heard of this story.

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