Prehospital Plasma Cuts Mortality Risk in Hemorrhagic Shock
THURSDAY, July 26, 2018 -- Prehospital administration of thawed plasma during air medical transport results in lower 30-day mortality compared with standard-care resuscitation in injured patients at risk for hemorrhagic shock, according to research published in the July 26 issue of the New England Journal of Medicine.
Jason L. Sperry, M.D., M.P.H., from the University of Pittsburgh Medical Center, and colleagues examined the efficacy and safety of prehospital administration of thawed plasma in injured patients at risk for hemorrhagic shock in a phase 3 superiority trial. A total of 501 patients were evaluated: Thawed plasma was administered to 230 patients, while 271 received standard-care resuscitation.
The researchers found that 30-day mortality was significantly lower in the plasma versus the standard-care group (23.2 versus 33 percent). Across nine prespecified subgroups, a similar treatment effect was seen. An early separation of the two treatment groups was observed with Kaplan-Meier curves; it began three hours after randomization and persisted until 30 days post-randomization. After the patients' arrival at the trauma center, the plasma group had lower median prothrombin-time ratio than the standard-care group (1.2 versus 1.3).
"In injured patients at risk for hemorrhagic shock, the prehospital administration of thawed plasma was safe and resulted in lower 30-day mortality and a lower median prothrombin-time ratio than standard-care resuscitation," the authors write.
One author disclosed financial ties to the biopharmaceutical industry and is named on a patent on TLR4 inhibitors for treatment of human inflammatory and infectious diseases.
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Posted: July 2018