Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial.

Area of Science:

• Trauma resuscitation
• Blood product transfusion
• Hemorrhagic shock management

Background:

• Limited data exist on the safety and efficacy of early cold stored platelet transfusion in severe trauma.
• Hemorrhagic shock necessitates timely interventions to improve patient outcomes.

Purpose of the Study:

• To assess the feasibility, efficacy, and safety of early cold stored platelet transfusion versus standard care in patients with hemorrhagic shock.
• To evaluate the impact on 24-hour mortality and thrombotic complications.

Main Methods:

• Phase 2, multicenter, randomized, open-label clinical trial involving 5 US trauma centers.
• Patients at risk for massive transfusion and hemorrhage control procedures were randomized.
• Intervention: early transfusion of a single apheresis cold stored platelet unit (stored ≤14 days) vs. standard care.

Main Results:

• 24-hour mortality was 5.9% in the early cold stored platelet group vs. 10.2% in the standard care group (P=0.26).
• No significant differences were observed in ancillary outcomes.
• Rates of thromboembolism and adverse events did not differ between groups.

Conclusions:

• Early cold stored platelet transfusion is feasible and safe in severely injured patients.
• This transfusion strategy did not significantly lower 24-hour mortality compared to standard care.
• No increased risk of thrombotic complications or adverse events was identified.