A new blood product could help to improve survival rates of individuals with a penetrating major trauma injury, according to the findings of a UK trial.
NHSBT Blood and Transplant developed a new transfusion product, which contains red blood cells and plasma unmixed in one bag and is given as a single transfusion in the pre-hospital emergency setting.
A study by NHS Blood and Transplant, Queen Mary University London, and Barts Health NHS Trust involved 909 major traumatic haemorrhages patients who met the trial criteria, all of whom were treated by Air Ambulances in England.
Patients treated between 2018-2020 received the new mixed product or separate transfusions of red blood cells and plasma. Their survival outcomes were compared to a retrospective group who only received red blood cells, treated between 2015-2018.
Writing in the journal Critical Care, the authors say the odds of surviving 24 hours were around 1.5 times higher in patients who received combined red cells and plasma than those who received red cells alone.
They now want larger trials to confirm these findings.
Chief investigator Dr Laura Green, a consultant haematologist for NHS Blood and Transplant and Barts Health NHS Trust, and reader in transfusion medicine at the Blizard Institute of Queen Mary University of London, said: “The majority of trauma deaths are within three hours.
“We know patients benefit from getting not just red blood cells but also plasma, but it’s difficult to quickly carry out multiple transfusions in an urgent pre-hospital setting – such as by the road side at night following a major crash, where a patient might have minutes to live.
“The study provides evidence that this new product, which contains both plasma and red blood cells unmixed in one bag, also saves more lives than just giving red blood cells alone.
“Now it can be explored further as a potential lifesaving new treatment which can be used outside of hospitals.”
The trial was funded by London Air Ambulance, Barts Charity and NHS Blood and Transplant.
Tucker H, Brohi K, Tan J, Aylwin C, Bloomer R, Cardigan R, Davenport R, Davies ED, Godfrey P, Hawes R, Lyon R, McCullagh J, Stanworth S, Thompson J, Uprichard J, Walsh S, Weaver A, Green L. (2023) “Association of red blood cells and plasma transfusion versus red blood cell transfusion only with survival for treatment of major traumatic haemorrhage in prehospital setting in England: a multicentre study.” Critical Care, doi: 10.1186/s13054-022-04279-4
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