Trauma experts trial use of new enhanced blood transfusion to improve survival

Major trauma is the term used to describe damage caused to the body by an external source, such as a road accident or stabbing, and it accounts for around 5,400 deaths in England every year.

It is the most common cause of death in people under the age of 45, often as a result of uncontrolled bleeding.

Currently, patients receive blood transfusions first and a frozen blood product separately later on as part of the standard resuscitation process.

Known as cryoprecipitate, it contains high levels of the blood clotting protein fibrinogen which acts as a ‘glue’ to hold blood clots together.

When a patient is low on fibrinogen, clots do not form properly and, as a result, the body cannot stop significant blood loss.

Now, trauma specialists at University Hospital Southampton NHS Foundation Trust are studying whether or not giving patients cryoprecipitate and transfusions together within 90 minutes of arrival at hospital can stop blood loss sooner.

“Patients who have severe bleeding after injury develop a problem with their clotting system which means that they tend to bleed more,” explained Dr Bentley Waller (pictured), a consultant anaesthetist who is leading the Southampton study.

“One of the main problems is due to low levels of fibrinogen, a clotting protein normally circulating in the bloodstream, so by giving patients cryoprecipitate early on to raise these levels it may be possible to make clots more stable and reduce bleeding.

“What this study – the largest ever carried out into traumatic major haemorrhage – will tell us is whether or not giving cryoprecipitate treatment earlier reduces death rates in trauma patients with severe bleeding.”

Professor Robert Crouch, a consultant nurse in emergency care and deputy director of major trauma at UHS, added: “This is a major study which could have a significant impact on the treatment trauma patients receive across the world.

“Major trauma care is always a real team effort and this study encompasses that, with paramedics, the hospital-based trauma team and research staff all working closely to identify appropriate patients.

“This includes blood transfusion biomedical scientists who play a key role in delivering the trial and, importantly, rapidly provide the blood products needed.”

This study, known as CRYOSTAT-2, is taking place at all major trauma centres in England, along with centres in Wales and the US, and is being coordinated by researchers at NHS Blood and Transplant and Queen Mary University London.

For more information on the study, which is funded by the National Institute for Health Research, visit https://cryostat2.co.uk/.