Civilian trauma study supports use of battlefield blood transfusion protocol
The Medical College of Wisconsin Department of Surgery, Division of Trauma and Critical Care took part in a national, multi-center study to compare how severely injured patients are given blood transfusions necessary to save their lives. The study took place at Froedtert & the Medical College from January to December 2013. It was designed to compare the effectiveness of different blood product ratios (Platelets, Plasma, and Red Blood Cells).
Locally, 42 patients were enrolled in the study (which enrolled a total of 680 patients.) The results were published in the Journal of the American Medical Association in an article titled “Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 ratio vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma: The PROPPR Randomized Clinical Trial.” In summary, it was found that there was reduced risk of death due to blood loss during the first 24 hours when a ratio using more platelets and plasma was used. This group was given more units of plasma and platelets than the other group, but their bleeding was better controlled and there was no difference in death or other complications between the two groups.
“We could not have completed this study without the support of the local community. This is an extremely important study as it incorporates the lessons physicians have learned from recent overseas conflicts,” stated Medical College surgeon, Dr. David Milia. Drs Karen Brasel and Milia were the site investigators for the Medical College of Wisconsin along with research coordinator, Pamela Walsh. Participating centers, in addition to the Medical College of Wisconsin, included UTHealth/Memorial Hermann-Texas Medical Center, the University of Alabama, the University of Arizona, the University of California, Los Angeles, the University of California, San Francisco, the University of Maryland School of Medicine, the University of Cincinnati, Oregon Health and Science University, the University of Tennessee Health Science Center, the University of Washington/Harborview Medical Center, and Sunnybrook Health Science Center in Toronto.
PROPPR is a protocol of the Resuscitation Outcomes Consortium, which is funded by the NHLBI, the U.S. Department of Defense, the Defense Research and Development Canada, and the Canadian Institute of Health Research of Circulatory and Respiratory Health. For more information visit: http://www.mcw.edu/Trauma-Critical-Care/Research/PROPPR.htm.