Methodology: 3.5/5
Usefulness: 4/5
Davenport R, et al. JAMA. 2023 Oct 12:e2321019.
Editorial: Contemporary Adjuncts to Hemorrhage Control.
Question and Methods: In trauma patients with major hemorrhage, does early cryoprecipitate (6g fibrinogen) administration improve survival, compared to standard care?
Findings: There was no difference in all-cause mortality at 28 days (25.35 vs. 26.1%); OR 0.96 [95% CI 0.75-1.23] p=0.74
Limitations: Cross over between groups (15% of cryoprecipitate group didn’t receive any, 9% of control group received cryoprecipitate within 90mins) though per protocol analysis this didn’t impact the results.
Interpretation: Addition of early and empiric cryoprecipitate to standard care among adult trauma patients with major hemorrhage protocol activation, did not improve all cause 28-day mortality.
JC Supervisor: Dr. Venkatesh Thiruganasambandamoorthy
Authors
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Dr. Mejbel Alazemi is a junior editor for the EMOttawa Blog, and is a FRCPC resident in the Department of Emergency Medicine, at the University of Ottawa.
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Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
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Dr. Venkatesh Thiruganasambandamoorthy is an attending physician and associate scientist at the Ottawa Hospital and Ottawa Hospital Research Institute with an particular interest in syncope and presyncope care.
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