dc.contributor.author | Baksaas-Aasen, K | |
dc.contributor.author | Gall, LS | |
dc.contributor.author | Stensballe, J | |
dc.contributor.author | Juffermans, NP | |
dc.contributor.author | Curry, N | |
dc.contributor.author | Maegele, M | |
dc.contributor.author | Brooks, A | |
dc.contributor.author | Rourke, C | |
dc.contributor.author | Gillespie, S | |
dc.contributor.author | Murphy, J | |
dc.contributor.author | Maroni, R | |
dc.contributor.author | Vulliamy, P | |
dc.contributor.author | Henriksen, HH | |
dc.contributor.author | Pedersen, KH | |
dc.contributor.author | Kolstadbraaten, KM | |
dc.contributor.author | Wirtz, MR | |
dc.contributor.author | Kleinveld, DJB | |
dc.contributor.author | Schaefer, N | |
dc.contributor.author | Chinna, S | |
dc.contributor.author | Davenport, RA | |
dc.contributor.author | Naess, PA | |
dc.contributor.author | Goslings, JC | |
dc.contributor.author | Eaglestone, S | |
dc.contributor.author | Stanworth, S | |
dc.contributor.author | Johansson, PI | |
dc.contributor.author | Gaarder, C | |
dc.contributor.author | Brohi, K | |
dc.date.accessioned | 2020-11-19T15:07:55Z | |
dc.date.available | 2020-09-20 | |
dc.date.available | 2020-11-19T15:07:55Z | |
dc.date.issued | 2020-10-13 | |
dc.identifier.citation | Baksaas-Aasen, K., Gall, L.S., Stensballe, J. et al. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. Intensive Care Med (2020). https://doi.org/10.1007/s00134-020-06266-1 | en_US |
dc.identifier.issn | 0342-4642 | |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/68519 | |
dc.description.abstract | Purpose: Contemporary trauma resuscitation prioritizes control of bleeding and uses major haemorrhage protocols
(MHPs) to prevent and treat coagulopathy. We aimed to determine whether augmenting MHPs with Viscoelastic Haemostatic
Assays (VHA) would improve outcomes compared to Conventional Coagulation Tests (CCTs).
Methods: This was a multi-centre, randomized controlled trial comparing outcomes in trauma patients who received
empiric MHPs, augmented by either VHA or CCT-guided interventions. Primary outcome was the proportion of subjects
who, at 24 h after injury, were alive and free of massive transfusion (10 or more red cell transfusions). Secondary
outcomes included 28-day mortality. Pre-specified subgroups included patients with severe traumatic brain injury
(TBI).
Results: Of 396 patients in the intention to treat analysis, 201 were allocated to VHA and 195 to CCT-guided therapy.
At 24 h, there was no difference in the proportion of patients who were alive and free of massive transfusion (VHA:
67%, CCT: 64%, OR 1.15, 95% CI 0.76–1.73). 28-day mortality was not different overall (VHA: 25%, CCT: 28%, OR 0.84,
95% CI 0.54–1.31), nor were there differences in other secondary outcomes or serious adverse events. In pre-specified
subgroups, there were no differences in primary outcomes. In the pre-specified subgroup of 74 patients with TBI, 64%
were alive and free of massive transfusion at 24 h compared to 46% in the CCT arm (OR 2.12, 95% CI 0.84–5.34).
Conclusion: There was no difference in overall outcomes between VHA- and CCT-augmented-major haemorrhage
protocols. | en_US |
dc.publisher | Springer | en_US |
dc.relation.ispartof | INTENSIVE CARE MEDICINE | |
dc.rights | This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. | |
dc.subject | Trauma | en_US |
dc.subject | Haemorrhage | en_US |
dc.subject | Coagulopathy | en_US |
dc.subject | Thrombelastography | en_US |
dc.subject | Thromboelastometry | en_US |
dc.title | Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial | en_US |
dc.type | Article | en_US |
dc.rights.holder | © 2020 The Author(s) | |
dc.identifier.doi | 10.1007/s00134-020-06266-1 | |
pubs.author-url | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000578323800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=612ae0d773dcbdba3046f6df545e9f6a | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.publisher-url | http://doi.org/10.1007/s00134-020-06266-1 | |
dcterms.dateAccepted | 2020-09-20 | |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |