Taking the Blood Bank to the Field

The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial

Joshua B. Brown, Francis X. Guyette, Matthew D. Neal, Jeffrey A. Claridge, Brian J. Daley, Brian G. Harbrecht, Richard S. Miller, Herb A. Phelan, Peter W. Adams, Barbara J. Early, Andrew B. Peitzman, Timothy R. Billiar, Jason L. Sperry

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Hemorrhage and trauma induced coagulopathy remain major drivers of early preventable mortality in military and civilian trauma. Interest in the use of prehospital plasma in hemorrhaging patients as a primary resuscitation agent has grown recently. Trauma center-based damage control resuscitation using early and aggressive plasma transfusion has consistently demonstrated improved outcomes in hemorrhaging patients. Additionally, plasma has been shown to have several favorable immunomodulatory effects. Preliminary evidence with prehospital plasma transfusion has demonstrated feasibility and improved short-term outcomes. Applying state-of-the-art resuscitation strategies to the civilian prehospital arena is compelling. We describe here the rationale, design, and challenges of the Prehospital Air Medical Plasma (PAMPer) trial. The primary objective is to determine the effect of prehospital plasma transfusion during air medical transport on 30-day mortality in patients at risk for traumatic hemorrhage. This study is a multicenter cluster randomized clinical trial. The trial will enroll trauma patients with profound hypotension (SBP ≤ 70 mmHg) or hypotension (SBP 71-90 mmHg) and tachycardia (HR ≥ 108 bpm) from six level I trauma center air medical transport programs. The trial will also explore the effects of prehospital plasma transfusion on the coagulation and inflammatory response following injury. The trial will be conducted under exception for informed consent for emergency research with an investigational new drug approval from the U.S. Food and Drug Administration utilizing a multipronged community consultation process. It is one of three ongoing Department of Defense-funded trials aimed at expanding our understanding of the optimal therapeutic approaches to coagulopathy in the hemorrhaging trauma patient.

Original languageEnglish (US)
Pages (from-to)343-350
Number of pages8
JournalPrehospital Emergency Care
Volume19
Issue number3
DOIs
StatePublished - Jul 3 2015

Fingerprint

Blood Banks
Air
Resuscitation
Wounds and Injuries
Trauma Centers
Hypotension
Investigational Drugs
Hemorrhage
Drug Approval
Mortality
United States Food and Drug Administration
Informed Consent
Tachycardia
Emergencies
Referral and Consultation
Randomized Controlled Trials
Research

Keywords

  • Clinical trial
  • Helicopter
  • Plasma
  • Prehospital
  • Randomized
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency

Cite this

Brown, J. B., Guyette, F. X., Neal, M. D., Claridge, J. A., Daley, B. J., Harbrecht, B. G., ... Sperry, J. L. (2015). Taking the Blood Bank to the Field: The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial. Prehospital Emergency Care, 19(3), 343-350. https://doi.org/10.3109/10903127.2014.995851

Taking the Blood Bank to the Field : The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial. / Brown, Joshua B.; Guyette, Francis X.; Neal, Matthew D.; Claridge, Jeffrey A.; Daley, Brian J.; Harbrecht, Brian G.; Miller, Richard S.; Phelan, Herb A.; Adams, Peter W.; Early, Barbara J.; Peitzman, Andrew B.; Billiar, Timothy R.; Sperry, Jason L.

In: Prehospital Emergency Care, Vol. 19, No. 3, 03.07.2015, p. 343-350.

Research output: Contribution to journalArticle

Brown, JB, Guyette, FX, Neal, MD, Claridge, JA, Daley, BJ, Harbrecht, BG, Miller, RS, Phelan, HA, Adams, PW, Early, BJ, Peitzman, AB, Billiar, TR & Sperry, JL 2015, 'Taking the Blood Bank to the Field: The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial', Prehospital Emergency Care, vol. 19, no. 3, pp. 343-350. https://doi.org/10.3109/10903127.2014.995851
Brown, Joshua B. ; Guyette, Francis X. ; Neal, Matthew D. ; Claridge, Jeffrey A. ; Daley, Brian J. ; Harbrecht, Brian G. ; Miller, Richard S. ; Phelan, Herb A. ; Adams, Peter W. ; Early, Barbara J. ; Peitzman, Andrew B. ; Billiar, Timothy R. ; Sperry, Jason L. / Taking the Blood Bank to the Field : The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial. In: Prehospital Emergency Care. 2015 ; Vol. 19, No. 3. pp. 343-350.
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