Plasma on Board

LifeFlight Infusions Could Boost Survival

Anne Rayner

 

Vanderbilt is taking part in a national trial to see if outcomes for critically injured patients with uncontrolled bleeding can be improved by administering plasma while in flight to the hospital. In a first-of-its-kind study, randomized patients who are at risk of hemorrhaging and flown to Vanderbilt University Hospital via LifeFlight’s Clarksville, Tenn., base will receive two units of plasma, which has the potential to improve patients’ ability to clot and ultimately survive their injuries.

Funded by the U.S. Department of Defense, the Prehospital Air Medical Plasma (PAMPer) trial will assess whether a prehospital infusion of AB plasma, the universal donor plasma, can improve mortality and reduce the total number of blood transfusions.

“When patients are critically ill, their ability to clot is severely impaired,” says Dr. Richard Miller, chief of trauma and surgical critical care, professor of surgery, and primary investigator for the Vanderbilt PAMPer trial site. “The thought process on this study is that the plasma, which is separated from blood cells when a person donates blood, will improve the body’s ability to clot and thus improve the patient’s chance of arriving at our hospital alive.”

The plasma will be administered in addition to standard of care, which already includes packed red blood-cell transfusion in flight when needed. Vanderbilt LifeFlight, Tennessee’s largest not-for-profit air medical transport program, is the only air medical service in the region that carries blood for transfusions while in flight. The Clarksville-based aircraft is the only one of LifeFlight’s fleet of five helicopters that will carry plasma.

Led by the University of Pittsburgh, the four-year study will enroll 530 patients across six sites. Vanderbilt will enroll patients beginning early this year. Researchers will compare the effect of the prehospital infusion of plasma versus current standard of care on 30-day mortality in patients with hemorrhagic shock. They also will examine clinical outcomes, including blood transfusion requirements and the development of multiple organ failure.

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