The Lancet Hematology
March 7, 2022
Resuscitation with blood products in patients with trauma-related hemorrhagic shock receiving prehospital care.
What was the research question?
Is the pre-hospital resuscitation with blood transfusion and Lyophilised Plasma (intervention) in severely injured patients with hemorrhagic shock and hypotension (population) associated with better tissue perfusion and event mortality (outcome) compared to the use of NS (comparator)?
How did they do it?
A multicentre, open-label, randomised, controlled, phase 3 trial with 1:1 randomization in four intensive care units in the United Kingdom, with a composite outcome of episode mortality or impaired lactate clearance, or both, measured in the intention-to-treat population.
What did they find?
Out of 432 severely injured patients with hemorrhagic shock and hypotension were randomized to receive PRBC-Locals (209) or 0.9% NS (223). Median age was 38 years, 82% were males, and median injury severity score of 36 3. Composite outcome of event mortality (death at any time) or impaired lactate clearance was not statistically different between the two group, nor was the individual components of the composite outcome.
What does it mean?
Pre-hospital resuscitation of hemorrhagic shock patients with blood products is not better than normal saline in terms of tissue perfusion or event mortality.