St. Emlyn´s - By Simon Carley - October 30, 2020
...CRASH 3 was one of the standout papers of the year. It showed that TXA was likely most effective in the group of patients in whom further bleeding (and thus its prevention) was likely. The principle of managing the secondary brain injury by reducing the amount of bleeding from cerebral contusions and blood collections certainly makes pathophysiological sense, with TXA affecting fibrinolysis, but what of other aspects of the clotting mechanism?
Back in 2018 the PAMPER trial reported on the outcome of a prehospital randomised controlled trial of early plasma use in trauma patients. We reviewed the paper on St Emlyn’s here. In brief this was an RCT of 501 patients in whom a 10% benefit in terms of mortality was found. This is a remarkable effect which certainly raised some skeptical eyebrows, but there are plausible reasons why it might be true.
This month we have a secondary analysis of the PAMPER trial with a particular focus on those patients with traumatic brain injury. The abstract is below, but as always we strongly recommend that you read the full paper..."
