THE STTTOPPP The bleeding randoMiZed controlled trial

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THE STTTOPPP The bleeding randoMiZed controlled trial Martin L Tonglet, MD, PhD student, Liege University Hospital, Belgium 11th EUPHOREA meeting, Glasgow, April 25th 2017 THE STTTOPPP The bleeding randoMiZed controlled trial

The STOP the bleeding campaign. “The campaign aims to reduce the number of patients who die within 24 hours after arrival in the hospital due to exsanguination by a minimum of 20% within the next 5 years.” Rosaint et al. Crit Care. 2013 Apr 26;17(2):136.

Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma (CME). de Biasi AR1, Stansbury LG, Dutton RP, Stein DM, Scalea TM, Hess JR. Transfusion. 2011 Sep;51(9):1925-32

Prehospital Air Medical Plasma (PAMPer) Trial

Remote Damage Control Resuscitation - RDCR

Impact of plasma transfusion in trauma patients who do not require massive transfusion. Inaba K1, Branco BC, Rhee P, Blackbourne LH, Holcomb JB, Teixeira PG, Shulman I, Nelson J, Demetriades D. J Am Coll Surg. 2010 Jun;210(6):957-65

A medical need

What can we do so far ?

Two questions 1- How could we reduce delta t ? 2- How could we take advantage from delta t ?

The Trauma Induced Coagulopathy Clinical Score

The Trauma Induced Coagulopathy Clinical Score

Prehospital identification of trauma patients in need for transfusion: results of a retrospective study on 33,385 patients from the TraumaRegister DGU® evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS). Tonglet et al. in press

Impact ? The STTTOPPP the bleeding RCT Question: What is the impact of a prehospital discrimination (using TICCS) of trauma requiring or not EAHR ? Primary outcome: difference in 7 days mortality. Secondary outcomes: 30 days mortality, total number of blood products transfused, total hospital length of stay.

The STTTOPPP the bleeding RCT Randomization CONTROL GROUP INTERVENTION GROUP TICCS CALCULATION LOCAL USUAL PROTOCOL OF CARE TICCS < 10 TICCS ≥ 10 None of the STTTOPPP components (except trauma team) STTTOPPP the bleeding protocol 7 days mortality, 30 days mortality, total blood products transfused, total hospital length of stay

The STTTOPPP the bleeding RCT

The STTTOPPP the bleeding RCT

The STTTOPPP the bleeding RCT

www.researchgate.net Martin L Tonglet Interested ? Please contact me: tongletm@yahoo.com www.researchgate.net Martin L Tonglet Dr Martin Tonglet Service des urgences CHU du Sart Tilman Domaine du Sart Tilman B36 4000 LIEGE +32 4 284 37 35 +32 478 519 450