Trauma specialists based at Southampton General Hospital’s major trauma centre are participating in a multi-centre international study of a frozen blood product to try and improve survival rates for patients with major trauma haemorrhage.
Dr Suzanne Kellett, consultant anaesthetist at University Hospital Southampton NHS Foundation Trust, and her team are leading the Southampton-arm of the study and will assess the effect of cryoprecipitate, a frozen blood clotting product prepared from plasma, on adult patients with severe injuries and major bleeding.
Improving survival rates
Worldwide, it is estimated that 5.8 million people die from major trauma injuries each year, with major trauma haemorrhage, or uncontrolled bleeding, the most common cause of death in this patient group.
When a person is suffering major bleeding they receive emergency treatment known as ‘standard major haemorrhage therapy’ on admission to hospital. This includes a blood transfusion to help control and stop the bleed. As well as red blood cells and platelets, cryoprecipitate is included in the transfusion as it contains high levels of the blood clotting protein, fibrinogen.
“Fibrinogen acts as a ‘glue’ to hold a blood clot together. At low levels – including during a major bleed – blood clots don’t form properly and bleeding can continue.” Dr Kellett explained.
Approximately 1,500 patients will be recruited to this study, CYROSTAT-2, across all study sites. They will be randomised with half going on to receive an early dose of cryoprecipitate – within 90 minutes of them arriving at hospital – and others receiving the current standard major haemorrhage therapy, which administers cryoprecipitate later on in the treatment procedure.
“By transfusing cryoprecipitate, which is rich in fibrinogen, early to replace levels in bleeding trauma patients, we believe blood clots will be more stable, reducing bleeding and consequently the number of deaths,” Dr Kellett added.
The two different treatment approaches will then be compared by assessing patient survival rates which will help doctors understand whether giving cryoprecipitate earlier can help save more lives.
Finessing patient care
“There’s nothing dangerous or risky about taking part in this study; This study is simply trying to finesse the care we already give patients. By being involved in research, these patients are helping us to improve care standards and build on work we have already done in the hope of saving more lives,” explained Dr Kellett.
This study, which is taking place at all 23 major trauma centres in England, is being coordinated by researchers at NHS Blood and Transplant and Queen Mary University London and funded by the National Institute for Health Research.
For more information, visit www.cryostat2.co.uk
Posted on Tuesday 4 December 2018