closure of pragmatic, randomized optimal platelet and plasma ratios (proppr) study thomas scalea, md...
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Background Nearly 50% of trauma deaths occur before the patient reaches the hospital and few of these deaths are preventable For those that reach the hospital, about 40% experience bleeding complications and require a MT (massive transfusion of at least 10 units of blood) Bleeding complications are the leading cause of early death in trauma patientsTRANSCRIPT
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Closure of Pragmatic, Randomized Optimal Platelet and Plasma Ratios
(PROPPR) Study
Thomas Scalea, MDPhysician-in-Chief
R Adams Cowley University of Maryland Shock Trauma Center
Sponsored by National Heart Lung and Blood Institute (NHLBI), National Institutes for Health (NIH)
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What was the PROPPR study?• Conducted between August 2012 and
December 2013 at 12 Level 1 trauma centers in North America
• Purpose: To compare two different methods of blood transfusion to learn which one improves survival
• Enrolled patients who were PREDICTED to need a very large amount of blood
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Background• Nearly 50% of trauma deaths occur
before the patient reaches the hospital and few of these deaths are preventable
• For those that reach the hospital, about 40% experience bleeding complications and require a MT (massive transfusion of at least 10 units of blood)
• Bleeding complications are the leading cause of early death in trauma patients
![Page 4: Closure of Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Study Thomas Scalea, MD Physician-in-Chief R Adams Cowley University of Maryland](https://reader036.vdocuments.net/reader036/viewer/2022062317/5a4d1b527f8b9ab0599a8282/html5/thumbnails/4.jpg)
What Are Blood Products?• When blood is donated, it is divided
into its main active parts (or blood products) of plasma, platelets and red blood cells
• Plasma is the liquid portion of the blood; it represents approximately 50% of the total volume of blood and contains coagulation proteins
• Platelets are the smallest structures in the blood and are important for blood clotting and plugging damaged blood vessels
• Red blood cells are cells that carry oxygen
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Blood Product Combinations• Two blood product combinations in
widespread use across the United States: – Equal ratios of plasma, platelets and red blood
cells– A ratio that has equal numbers of plasma and
platelets, but twice as many red blood cells
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PROPPR Study Design• 11,185 patients screened• 680 enrolled – 338 in 1:1:1 ratio group– 342 in 1:1:2 ratio group
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Results• Patients in the 1:1:1 ratio group lived long
enough for physicians to stop the bleeding and had a better chance of surviving, in the first 24 hours, compared to patients in the other group
• The two groups had the same overall level of survival at 30 days
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Community Notification• Patients are usually told ahead of time about a
research study so they can provide consent before participating
• In an emergency, it is often impossible for patients to give consent
• This study met FDA guidelines to be carried out without first obtaining consent
• People who obtained an opt-out bracelet may discard it at this time
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Want to learn more?• Contact:
Anthony HerreraClinical Research Specialist University of Maryland School of Medicine 410-328-4698 [email protected]