Alternative Plasma Thawers for Austere Resuscitative Surgical Teams: Literature Review

The purpose of this literature review is to iden-tify optimal alternative fresh frozen plasma thawing devices for Austere Resuscitative and Surgical Care (ARSC) teams op-erating in far forward settings constrained by logistical and operational requirements. The authors reviewed ex-isting literature to identify optimal alternative plasma thawing devices and assessed power consumption, weight, durability, portability, post-thaw coagulation preservation, and thaw ki-netics. Field-adapted plasma thawers and other commercially available plasma thawing systems were analyzed to determine their suitability to meet the needs of ARSC teams. Sixteen ar-ticles were included after evaluating methodological quality and strength of evidence. The authors recom-mend that ARSC teams use whole blood, liquid plasma, and FDA-approved thawing devices whenever available. However, if these options are not feasible, alternative methods should be considered to meet mission requirements. Among the devices reviewed, the sous vide demonstrated potential for this appli-cation. They are lightweight, compact, versatile, and capable of creating target temperature-controlled circulating water baths, making them superior when compared to other iden-tified field-adapted devices. Dry-based thawing systems, such as the ZipThaw®, may also offer advantages by conserving resources like water and electricity; however, further research is needed to validate its effectiveness in forward operating environments.