A5045934923- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Abdominal Trauma and Injuries
- Cardiac Arrest and Resuscitation
- Blood transfusion and management
- Pelvic and Acetabular Injuries
- Childhood Cancer Survivors' Quality of Life
- Emergency and Acute Care Studies
- Acute Lymphoblastic Leukemia research
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac, Anesthesia and Surgical Outcomes
- Venous Thromboembolism Diagnosis and Management
- Sepsis Diagnosis and Treatment
- Occupational and environmental lung diseases
- Meta-analysis and systematic reviews
- Global Cancer Incidence and Screening
- Neonatal Respiratory Health Research
- Trauma Management and Diagnosis
- Agriculture and Farm Safety
- School Choice and Performance
- Prenatal Screening and Diagnostics
- Health and Medical Research Impacts
- Abdominal Surgery and Complications
- Blood donation and transfusion practices
- Statistical Methods in Clinical Trials
Inuit Tapiriit Kanatami
2025
The University of Texas Health Science Center at Houston
2015-2024
University of Houston
2013-2023
University of Colorado Denver
2018-2023
Canadian Institutes of Health Research
2023
Institute of Circulatory and Respiratory Health
2023
University of Southern California
2018-2023
University of Maryland, Baltimore
2017-2023
University of Washington
2015-2023
Methodist Hospital
2023
<h3>Importance</h3> Severely injured patients experiencing hemorrhagic shock often require massive transfusion. Earlier transfusion with higher blood product ratios (plasma, platelets, and red cells), defined as damage control resuscitation, has been associated improved outcomes; however, there have no large multicenter clinical trials. <h3>Objective</h3> To determine the effectiveness safety of transfusing severe trauma major bleeding using plasma, cells in a 1:1:1 ratio compared 1:1:2...
To relate in-hospital mortality to early transfusion of plasma and/or platelets and time-varying plasma:red blood cell (RBC) platelet:RBC ratios.Prospective cohort study documenting the timing transfusions during active resuscitation patient outcomes. Data were analyzed using time-dependent proportional hazards models.Ten US level I trauma centers.Adult patients surviving for 30 minutes after admission who received a at least 1 unit RBCs within 6 hours (n = 1245, original group) 3 total...
Background The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control (DCR). This guideline evaluates several aspects DCR including the role massive transfusion (MT) protocols, optimal target ratio plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, recombinant activated factor VII (rVIIa) tranexamic acid (TXA). Methods Using Grading Recommendations Assessment, Development Evaluation (GRADE) methodology,...
American College of Surgeons Trauma Quality Improvement Best Practices recommends initial massive transfusion (MT) cooler delivery within 15 minutes protocol activation, with a goal 10 minutes. The current study sought to examine the impact timing first on patient outcomes.Patients predicted receive MT at 12 Level I trauma centers were randomized two separate ratios as described in PROPPR trial. Assessment Blood Consumption score or clinician gestalt prediction was used randomize patients...
Importance Critical bleeding is associated with a high mortality rate in patients trauma. Hemorrhage exacerbated by complex derangement of coagulation, including an acute fibrinogen deficiency. Management replacement cryoprecipitate transfusions or concentrate, usually administered relatively late during hemorrhage. Objective To assess whether survival could be improved administering early and empirical dose to all trauma that required activation major hemorrhage protocol. Design, Setting,...
Few risk factors for childhood cancer are well-established. We investigated whether advancing parental age increases risk.
Acute traumatic coagulopathy (ATC) occurs after severe injury and shock is associated with increased bleeding, morbidity, mortality. The effects of ATC hemostatic resuscitation on outcome are not well-explored. PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study provided a unique opportunity to characterize coagulation the trauma.Blood samples were collected upon arrival subset PROMMTT patients. Plasma clotting factor levels prospectively assayed for factors. These...
Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine likelihood of its success. Recent Phase 3 trials and observational studies have used 24-h and/or 30-day all-cause mortality as primary some not exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective among 4,064 hemorrhaging patients provide new evidence to support earlier endpoints.
Transfusing platelets during massive hemorrhage is debated because of a lack high-quality evidence concerning outcomes in trauma patients. The objective this study was to examine the effect platelet transfusions on mortality severely injured This work analyzed PROPPR (Pragmatic, Randomized Optimal Platelet and Plasma Ratios) trial patients who received only first cooler blood products, which either did or not contain platelets. Primary were all-cause at 24 hours 30 days hemostasis. Secondary...
BACKGROUND The trauma transfusion literature has yet to resolve which is more important for hemorrhaging patients, transfusing plasma and platelets along with red blood cells (RBCs) early in resuscitation or gradually balancing product ratios. In a previous report of PROMMTT results, we found (1) platelet:RBC ratios increased during the 6 hours following admission, (2) patients achieving than 1:2 (relative <1:2) had significantly decreased 6-hour 24-hour mortality adjusting baseline...
BACKDROP Clinicians intuitively recognize that faster time to hemostasis is important in bleeding trauma patients, but these times are rarely reported. METHODS Prospectively collected data from the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial were analyzed. Hemostasis was predefined as no intraoperative requiring intervention surgical field or resolution of contrast blush on interventional radiology (IR). Patients who underwent an emergent (within 90 minutes) operating room...
To determine the feasibility, efficacy, and safety of early cold stored platelet transfusion compared with standard care resuscitation in patients hemorrhagic shock.
The risk of hepatoblastoma is strongly increased among children with very low birth weight (<1500 g). Because data on and other childhood cancers are sparse, we examined the malignancy in a large set.We combined case-control sets created by linking cancer registries California, Minnesota, New York, Texas, Washington states, which included 17672 diagnosed as having at 0 to 14 years age 57966 randomly selected control subjects. Unconditional logistic regression analysis was used examine...
Early predictors of massive transfusion (MT) would prevent undertriage patients likely to require MT. This study validates triggers using the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study.All enrolled in PROMMTT were analyzed. The initial emergency department value for each trigger (international normalized ratio [INR], systolic blood pressure, hemoglobin, base deficit, positive result Focused Assessment Sonography examination, heart rate, temperature, and...
Abstract The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such frequency infections in utero hormone exposures. We investigated the association between birth pooled case‐control dataset. subjects were drawn from population‐based registries births California, Minnesota, New York, Texas Washington. included 17,672 cases <15 years age who diagnosed 1980 to 2004 57,966 randomly selected controls born 1970–2004,...
Children of different racial/ethnic backgrounds have varying risks cancer. However, to the authors' knowledge, few studies date examined cancer occurrence in children mixed ancestry.This population-based case-control study among aged <15 years using linked and birth registry data from 5 US states 1978 through 2004. Data were available for 13,249 cases 36,996 controls selected records. Parental race/ethnicity was determined Logistic regression analysis used examine association with...
Holcomb, John B. MD; Fox, Erin E. PhD; Wade, Charles PhD on behalf of the PROMMTT Study Group Author Information
The classic definition of massive transfusion, 10 or more units red blood cells (RBCs) in 24 hours, has never been demonstrated as a valid surrogate for severe hemorrhage and can introduce survival bias. In addition, the fails to capture other products that clinician may have immediately available, use, during initial resuscitation. Assuming resuscitative fluids reflect patient illness, our objective was identify rate resuscitation intensity (RI) could serve an early sickness patients with...
BACKGROUND The Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial was a randomized clinical comparing survival after transfusion of two different blood component ratios for emergency resuscitation traumatic massive hemorrhage. Transfusion services supporting the study were expected to provide thawed plasma, platelets, red cells within 10 minutes request. STUDY DESIGN AND METHODS At 12 Level 1 trauma centers participating in PROPPR, components transfused delivery times...
BACKGROUND Delivery of intravenous crystalloid fluids (IVF) remains a tradition-based priority during prehospital resuscitation trauma patients. Hypotensive and targeted algorithms have been shown to improve patient outcomes. We hypothesized that receiving any IVF is associated with increased survival in patients compared no IVF. METHODS Prospective data from 10 Level 1 centers were collected. Patient demographics, volume, emergency department vital signs, lifesaving interventions,...