Type O Whole Blood and Assessment of AGE During Prehospital Resuscitation (TOWAR) Trial

TOWAR is a proposed 6-year (4-year enrollment) multicenter, open label, pre-hospital, randomized trial utilizing 10 level-1 trauma centers designed to determine the efficacy and safety of low titer whole blood resuscitation as compared to standard of care resuscitation in patients at risk of hemorrhagic shock and to appropriately characterize the hemostatic competency of whole blood relative to its age. Specific aims are to determine whether prehospital low titer whole blood as compared to standard prehospital resuscitation results in lower 30-day mortality and results in lower early mortality, blood and blood component transfusion requirements, incidence of coagulopathy, improved hemostasis and platelet function and to determine whether prehospital whole blood (age > 14 days) as compared to young whole blood (age 14 days) is associated with equivalent clinical outcomes, hemostasis, prevention of coagulopathy, and platelet function in patients at risk of hemorrhagic shock.