- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02086500
Study of Tranexamic Acid During Air and Ground Medical Prehospital Transport Trial (STAAMP Trial) (STAAMP)
Study of Tranexamic Acid During Air and Ground Medical Prehospital Transport Trial For Trauma Patients At Risk Of Hemorrhage (STAAMP Trial); Phase III Multicenter, Prospective, Randomized, Double Blind, Interventional Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: Traumatically injured patients continue to be plagued with uncontrolled hemorrhage resulting in significant morbidity and early mortality. A primary driving force for this unbridled hemorrhage is known to be the early coagulopathy which complicates severe injury. Trauma induced coagulopathy has been postulated to be an equilibrium imbalance between pro and anticoagulant factors, platelets, endothelium and fibrinolysis soon after injury. Recent evidence demonstrates that the early use of the antifibrinolytic agent tranexamic acid (TXA) after trauma center arrival results in improved survival in patients at risk for bleeding. Bringing this proven treatment to the prehospital arena and intervening earlier in those patients who would otherwise not be candidates for treatment has the real potential to further reduce or prevent the vicious hemorrhagic cascade, improve clinical outcomes and provide insight into the underlying mechanisms responsible for and which maximize its benefit.
Objective/Hypothesis: The primary hypothesis will be that prehospital infusion of tranexamic acid in patients at risk for bleeding will reduce the incidence of 30 day mortality. The secondary hypotheses include that prehospital tranexamic acid will reduce the incidence of hyperfibrinolysis, acute lung injury, multiple organ failure, nosocomial infection, mortality, early seizures, pulmonary embolism and early resuscitation needs, reduce or prevent the early coagulopathy as demonstrated by improving presenting INR and rapid thromboelastography parameters, reduce the early inflammatory response, plasmin levels, leukocyte, platelet and complement activation, and determine the optimal dosing of tranexamic acid post-injury.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Blunt or penetrating injured patients at risk of bleeding being transported via air or ground medical services from the scene of injury or from referring hospital to a definitive trauma center that is participating in the trial AND
- Within 2 hours of time of injury AND
Hypotension (Systolic Blood Pressure (SBP) < 90mmHg)
- At scene of injury or during air or ground medical transport
- Documented at referring hospital prior to air or ground medical transport arrival
OR
Tachycardia (heart rate >110 beats per minute)
- At scene of injury or during air or ground medical transport
- Documented at referring hospital prior to air or ground medical transport arrival
Exclusion Criteria:
- Age > 90 or < 18 years of age
- Inability to obtain intravenous access or intraosseous
- Documented (radiographic evidence) cervical cord injury with motor deficit
- Known prisoner
- Known pregnancy
- Traumatic arrest with > 5 minutes CPR without return of vital signs
- Penetrating cranial injury
- Traumatic brain injury with brain matter exposed
- Isolated drowning or hanging victims
- Wearing an opt out bracelet.
- Isolated fall from standing
- Patient or Family Objection at scene
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Prehospital Tranexamic Acid
1 gram of Tranexamic Acid will be given during emergency medical transport
|
1 gram of prehospital Tranexamic Acid
|
PLACEBO_COMPARATOR: Control
Identical volume of saline during emergency medical transport
|
Saline Control
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
30 Day Mortality
Time Frame: 30 Day
|
Because not all patients had available data regarding 30-day mortality (patients were discharged and there 30-day outcome was unable to be determined) there may be differences between the 30Day mortality relative to the other outcomes.
There were 5 and 4 patients from each arm that did not have 30-day outcome and thus are different.
|
30 Day
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
24 Hour Mortality
Time Frame: 24 Hours
|
24 Hours
|
Acute Lung Injury
Time Frame: 7 days
|
7 days
|
Multiple Organ Failure
Time Frame: 30 days
|
30 days
|
Nosocomial Infection
Time Frame: 30 days
|
30 days
|
24 Hour Total Blood Transfusion
Time Frame: 24 hours
|
24 hours
|
Hyperfinbrinolysis
Time Frame: 24 hours
|
24 hours
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- W81XWH1320080 IND 121102
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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