Trauma Clinical Trial
— WEBSTEROfficial title:
Whole Blood vs. Blood Components Therapy in the Hemostatic Resuscitation of Severe Trauma Patients: An Open-label, Randomized, Controlled Clinical Trial
NCT number | NCT05634109 |
Other study ID # | 1938 |
Secondary ID | |
Status | Recruiting |
Phase | Phase 3 |
First received | |
Last updated | |
Start date | January 14, 2023 |
Est. completion date | January 2025 |
This study aims to evaluate among trauma patients with hemorrhagic shock the clinical impact of hemostatic resuscitation between whole blood vs. blood components therapy in the following outcomes in a hierarchical analysis: mortality at 28 days and evolution of organ dysfunction.
Status | Recruiting |
Enrollment | 220 |
Est. completion date | January 2025 |
Est. primary completion date | February 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Adult patients (> 18 years) - Activating institutional trauma code for trauma patients with hemorrhagic shock. - Candidate for massive transfusion (Patient with an Assessment Blood Consumption (ABC) Score = 2 or at the discretion of the treating physician) - Concurrent availability of whole blood or blood component therapy Exclusion Criteria: - More than 4 hours from trauma to hospital admission - More than 2 hours from hospital admission to randomization - Transfusion of more than one packed red blood cell unit prior to randomization. - Patients who have undergone surgery (laparotomy, thoracotomy, or sternotomy) before hospital admission. - In-extremis patients with devastating injuries (expected to die within 60 minutes). - Blood group other than to O or A and positive Rh factor - Severe traumatic brain injury in which neurosurgical intervention is futile (partial decapitation, massive intracranial hemorrhage, or transcranial gunshot wounds). - Burns over 20% of the total body surface area. - Suspected airway burn. - Cardiopulmonary resuscitation (CPR) before arrival at the ED. - CPR for more than 5 minutes before randomization. - Do not resuscitate order. - Incarcerated/prisoners. - Known pregnancy in the ED. - Patient or legal representative who refuse to participate in clinical research studies. |
Country | Name | City | State |
---|---|---|---|
Colombia | Fundacion Clinica Valle del Lili | Cali | Valle Del Cauca |
Lead Sponsor | Collaborator |
---|---|
Fundacion Clinica Valle del Lili | Hospital Universitario del Valle Evaristo Garcia, University of Pittsburgh |
Colombia,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The primary outcome is a hierarchical outcome consisting of mortality at 28 days post-randomization and evolution of organ dysfunction (difference of Sequential Organ Failure Assessment (SOFA) score between day 1 and day 5 post-randomization). | The primary outcome is a hierarchical composite outcome that will be analyzed using the Win-Ratio test. The first level will be 28-day mortality. The "winner" will be the participant who survival; in case of a tie, the second level will be the difference in SOFA score between fifth and first day. The "winner" will be participant with the lowest difference. | 28 days post ED admission | |
Secondary | 24-hour mortality | The occurrence of deaths in the first 24 hours post-ED admission and we will document and record the time of death in hours. | First 24 hours post ED admission. | |
Secondary | In-hospital mortality | The occurrence of deaths during the hospital stays post-ED admission, and we will document and record the time of death in days. | 28 days post ED admission | |
Secondary | Multiple organ dysfunction incidence | Multiple organ dysfunction is a score = 3 in two or more systems evaluated by SOFA score. | 1-day / 3-day / 5-day / 7-day post-ED admission | |
Secondary | Evolution of Coagulopathy | We will evaluate the values of INR, fibrinogen, and MA-TEG during the admission and the first 24 hours post-ED admission. | Admission - 3 hours - 6 hours - 24 hours post-ED admission | |
Secondary | Intensive care unit-free days | ICU-free days | 28-days post-ED admission | |
Secondary | Hospital length stay-free days | Hospital length stay-free days | 28-days post-ED admission | |
Secondary | Blood transfusion requirements during the first 24 hours | The number of units of whole blood or blood components transfused. Comparisons will be according to the following references:
1 Unit of Whole blood = 1 Unit of packed red blood cells. 1 Unit of Whole Blood = 1 Unit of Plasma 1 Unit of Whole Blood = 1 Unit of Platelets |
Time frame 3 hours / 6 hours / 12 hours / 24 hours | |
Secondary | Proportion of participants with transfusional adverse reactions | We will document transfusional adverse reactions such as acute hemolytic reaction, anaphylaxis, non-hemolytic febrile transfusion reaction, allergy, and potassium and calcium electrolyte disorders. | 28-days post-ED admission | |
Secondary | Proportion of participants with adverse reactions | We will document adverse reactions such as acute lung injury, acute respiratory distress syndrome, pulmonary embolism, deep vein thrombosis, acute kidney injury with or without dialysis, stroke, myocardial infarction, cardiac arrest, sepsis, abdominal complications, and abdominal compartment syndrome | 28-days post-ED admission |
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