Prehospital Transfusion Strategy in Bleeding Patients
Prehospital Plasma or Red Blood Cell Transfusion Strategy in Major Bleeding; PRIEST Trial
The aim of study is to compare clinical and biochemical effect of three different transfusion strategies among patients with major hemorrhage requiring prehospital transfusion.
A) Present prehospital standard treatment including a mixture of plasma and Red blood cell transfusion (RBC) transfusion B) Red blood cell transfusion (RBC) only C) Plasma transfusion only
Hypothesis:
- Transfusion strategy including a mixture of RBC and plasma is superior as compared with only plasma or only RBC strategy in terms of initial treatment of circulatory shock (expressed as base deficit).
- Endothelial function and ability of clot formation is preserved to a greater extent in patients receiving plasma.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Rationale for the study:
The warranted clinical question to be unsolved is whether initial pre-hospital transfusion in bleeding patients should base on a strategy including plasma, RBC or combination of both.
Despite possible benefits, allogenic blood product are associated with side effects and pose significant logistic challenges in the prehospital environment. So far, a majority of the present knowledge is based on retrospective evaluations or clinical trials without relevant control groups.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Christian Fenger-Eriksen, PhD
- Phone Number: +45 7846 6912
- Email: christian.fenger-eriksen@viborg.rm.dk
Study Locations
-
-
-
Aarhus, Denmark
- Danish Air Ambulance
-
-
Central Jutland
-
Silkeborg, Central Jutland, Denmark, 8600
- Aarhus Universityhospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Major bleeding requiring prehospital transfusion
Exclusion Criteria:
- Transfusion with blood products already initiated
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Standard transfusion
Includes standard transfusion with a mixture of red blood cells and plasma
|
|
|
Active Comparator: Plasma
Transfusion with plasma
|
Compare two different transfusion strategies against standard transfusion regimen
|
|
Active Comparator: Red Blood cells
Transfusion with red blood cells
|
Compare two different transfusion strategies against standard transfusion regimen
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Base deficit
Time Frame: At hospital arrival (with in 1 hour)
|
Arterial-gas analysis upon arrival with parameter base deficit as primary outcome
|
At hospital arrival (with in 1 hour)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
30 days mortality
Time Frame: mortality within 30 days
|
Mortality, follow up in patient records
|
mortality within 30 days
|
|
Activated Partial Thromboplastin Time (APTT)
Time Frame: At hospital arrival (with in 2 hours)
|
Plasma sample analysed; APTT
|
At hospital arrival (with in 2 hours)
|
|
Endogenous thrombin potential (ETP)
Time Frame: At hospital arrival (with in 2 hours)
|
Plasma sample analysed; thrombin generation assay
|
At hospital arrival (with in 2 hours)
|
|
International Normalized Ratio (INR)
Time Frame: At hospital arrival (with in 2 hours)
|
Plasma sample analysed; INR
|
At hospital arrival (with in 2 hours)
|
|
Endothelium markers
Time Frame: At hospital arrival (with in 2 hours)
|
Plasma sample analysed; Syndecan-1
|
At hospital arrival (with in 2 hours)
|
|
Endothelium markers
Time Frame: At hospital arrival (with in 2 hours)
|
Plasma sample analysed; soluble thrombomodulin
|
At hospital arrival (with in 2 hours)
|
|
In hospital red blood cell transfusion requirements
Time Frame: Within in the first 24 hours after hospital arrival
|
Amount of red blood cells transfused as registered in patient electronic records
|
Within in the first 24 hours after hospital arrival
|
|
In hospital plasma transfusion requirements
Time Frame: Within in the first 24 hours after hospital arrival
|
Amount of plasma transfused as registered in patient electronic records
|
Within in the first 24 hours after hospital arrival
|
|
In hospital platelet transfusion requirements
Time Frame: Within in the first 24 hours after hospital arrival
|
Amount of platelet transfused as registered in patient electronic records
|
Within in the first 24 hours after hospital arrival
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Christian Fenger-Eriksen, Aarhus Universityhospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 1-10-72-289-20
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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