Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial

by , , | Jan 9, 2023 | 0 comments

Methodology: 4/5
Usefulness: 3/5

Crombie N, et al. Lancet Haematol. 2022 Apr;9(4):e250-e261. 

Question and Methods: Multicenter RCT investigating prehospital resuscitation using PRBC and plasma vs normal saline to improve tissue perfusion or mortality in adult trauma patients with hemorrhagic shock.
Findings: No difference in primary outcome in the PRBCs + plasma vs saline. 65% vs 64% with mortality of 43% v 45% (Adjusted RR 0.97: 0.78-1.20)
Limitations: Trial stopped early. Used a composite outcome which included a surrogate outcome. Limited applicability in most Canadian settings with large distances and long transport times.

Interpretation: No benefit demonstrated to justify the expense and resource utilization for use of PRBCs and lyophilized plasma in pre-hospital EMS treatment of adult trauma patients.

By: Dr. Stephen Andrews

JC Supervisor: Dr. Christian Vaillancourt

 

 

Authors

  • Stephen Andrews
  • Hans Rosenberg

    Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

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  • Christian Vaillancourt

    Senior Scientist, Clinical Epidemiology Program Ottawa Hospital Research Institute Full Professor, Emergency Medicine University of Ottawa Research Chair in Emergency Cardiac Resuscitation, Emergency Medicine University of Ottawa Associate Medical Director, Regional Paramedic Program for Eastern Ontario Research Interests: Dr. Vaillancourt's current research program focuses on pre-hospital care, specifically improving care and survival for cardiac arrest and trauma victims.

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