HOUSTON, TX — Researchers at The University of Texas Health Science Center at Houston (UTHealth) are looking into the use of cold-stored platelets as an early intervention for patients with injury and hemorrhagic shock. This research is part of a national trial.
Located at Memorial Hermann-Texas Medical Center, the UTHealth Center for Translational Injury Research is also launching a Houston site for the Cold Stored Platelet Early Intervention (CriSP) trial.
The acute management for severely injured and bleeding patients has been evolving in the last decade due to the use of blood products such as red blood cells, plasma, platelets, and whole blood now given early and in equal ratios.
However, deaths from traumatic hemorrhages continue to happen in the first few hours after coming to trauma centers. This case has drawn attention to the need for additional early interventions. Furthermore, trauma is the principal cause of death for people younger than 45.
Platelet transfusions are a vital component at the beginning of resuscitation and essential to early control of bleeding. However, as of present, platelets are not available in the prehospital or early resuscitation setting.
Typically, patients will not be given platelet transfusions until they have received multiple units of other blood products as storage requirements and limited shelf life.
Cold-stored platelets, which can be refrigerated and stored similar to other blood products, including red blood cells, plasma, and whole blood, could be more useful if administered to a patient soon after coming to the trauma center than later as is the current standard treatment.
Bryan Cotton MD, MPH, professor and the John B. Holmes Professor of the Clinical Sciences, will investigate the UTHealth trial site with McGovern Medical School at UTHealth.
“We have significantly reduced mortality from bleeding over the past 10 to 12 years, from greater than 50% for severely bleeding patients to the current 20-25%. Houston has led the way in identifying best practice for these patients and has performed many of the studies that have gotten us to where we are now. However, we haven’t been able to reduce further the mortality beyond 20-25%. This study will examine whether administering cold-stored platelets will reduce deaths from bleeding,” said Cotton, who also director of the UTHealth Trauma and Surgical Care Fellowship Program at Red Duke Trauma Institute at Memorial Hermann-TMC.
This randomized trial will involve 200 patients at seven level 1 trauma centers in the U.S who were severely bleeding due to trauma and predicted to get significant amounts of blood products.