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November 23, 2020
Working closely with our European partners, the INTRN group, C4TS have published the results of the Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy (iTACTIC) clinical trial. The clinical trial was one of the work packages in a five year, EU funded research grant which aimed to understand:
How trauma-induced coagulopathy (TIC) is treated across Europe
How much it costs to treat TIC (health and economic burden)
Why TIC develops
Review the effectiveness of treatments
Develop treatment algorithms for personalised care
The study paper published included 396 patients across six European Major Trauma Centres; the Royal London Hospital (UK), John Radcliffe Hospital (Oxford, UK), Oslo University Hospital (Norway), Kliniken der Stadt (Cologne, Germany), Academic Medical Centre (Amsterdam), Rigshospitalet (Copenhagen University Hospital, Denmark).
The primary aim of the trial was to investigate whether trauma patients, who had a bleeding abnormality (known as being coagulopathic/having TIC), had better survival at 28 days after their injury if they received personalised blood transfusions guided by:
Conventional coagulation tests – these are routinely run in the hospital laboratories and give key quantitative measures of key components of blood clotting such as circulating fibrinogen level (the main protein in blood clots), platelet counts (the main cells in blood clots) and the time taken for a blood clot to be made.
Viscoelastic haemostatic assays – run on machines that can be close by the patient in the emergency department or operating theatre. These tests stimulate a blood sample to generate a blood clot and can give qualitative readouts about how quickly the blood clot is made and how much fibrinogen and platelet are contributing to the size of the blood clot
The team hypothesized that personalising blood transfusion using VHA technology would improve survival and reduce the need for ten or more units of red blood cells to be transfused in the first 24 h after injury (referred to as a massive transfusion).
Although this didn’t appear to be the case from the data analysed in the study, when researchers looked at a subgroup of 74 patients who had a severe traumatic brain injury (TBI), it appeared that patients who received VHA guided blood transfusion had improved survival. This is something the group hope to take forward and further investigate.
Click Here for the study publication
Click Here for an accessible break down of the study
For more information, please visit: https://www.c4ts.qmul.ac.uk/intrn-projects/tactic
