Blood Supply in the Bundeswehr: Resilience in Operations and Defense

Blood and blood products are indispensable for routine care and a decisive capability in military trauma, particularly in hemorrhagic shock. Declining donor rates, short shelf lives, especially for platelets, and high logistical demands increase vulnerability. In large-scale combat operations, the demand for whole blood equivalents can rise sharply while evacuation timelines may be prolonged. This narrative review summarizes key planning factors, the roles of ColdStored Whole Blood and Dried Plasma in (remote) damage-control resuscitation, and the specific requirements of the Bundeswehr blood supply in national and alliance defense scenarios. The article highlights the need for accelerated regulatory pathways for cold-stored whole blood, reinforced civil-military cooperation, multinational interoperability, and standardized procedures for emergency collection and use of whole blood in the area of operations