Early Whole Blood for Patients Requiring Massive Transfusion after Major Trauma. Addendum
Addendum to final rept. 1 Mar 2012-30 Sep 2013
TEXAS UNIV HEALTH SCIENCE CENTER AT HOUSTON
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The acquired coagulopathy of trauma is responsible for a large percentage of early deaths in civilian trauma practice and is a major cause of battlefield mortality. Widespread recognition has provided a rationale for fundamental changes in the initial management of severely injured patients through prevention of hypothermia, damage control surgery, massive transfusion protocols and early triage to intensive care units for optimized resuscitation. Despite these major advances, hemorrhage remains a leading cause of early death in both civilian trauma and military combat casualty care. However, it is unclear how early whole blood will affect coagulopathy in this cohort of patients as compared to the current standard of care. This study assessed if patients who require massive transfusion could be accurately predicted early after emergency department arrival and assessed if the use of stored whole blood during initial resuscitation would reduce transfusion needs compared to transfusion with component therapy and thus improve outcome. The primary clinical project has completed enrollment, randomizing 115 subjects. Additionally, the two ancillary projects have completed analysis data collected from subjects in this study to characterize the complement, platelet and immune-inflammatory response after trauma as well as the effect of adiposity after shock and resuscitation in these severely injured patients.
- Medicine and Medical Research