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RDCR.org
Update on Cold vs Warm Stored Platelets in Bleeding CT Surgery
Patients. ClinicalTrialHaukelandUniversityHospital
Bergen
GEIRSTRANDENES,MD,NORNAVSOCTHORNETWORK.SOLSTRAND22JUNI2016
COLDSTOREDPLATELETCLINICALTRIAL
• Studyoutline:Atwo-armedrandomizedpilotstudywasdesignedtoevaluateifleukoreducedapheresisplateletsinPASstoredforupto7dayscold(4CPLT)oratroomtemperature(RTPLT)areequallyeffec[veintreatmentofpostopera[vebleedinginpa[entsundergoingmajorcardiothoracicsurgery.
• Complexcardiacsurgerylikelytorequireplatelettransfusion.
HYPOTHESIS
• Coldstoredapheresisplateletsareassafeandefficaciousasroomtemperaturestoredplatelets(aspartoftransfusionstrategyforbleedingpa[ents)
PRIMARYANDSECONDARYOBJECTIVES
• P:Tocomparechangeinplateletfunc[onandcoagula[onprofilethefirst24hours
• S:Chestdrainoutput(postopbleeding)• S:Totalamountofbloodproductstransfused• S:Adverseevents–transfusionreac[ons,tromboembolicevents
PATIENTPOPULATION
• Complexcardiacsurgerywithexpectedlongextracorporal[me(>120minutes)
• Likelytorequireplatelettransfusion• Typicalaor[carchsurgerydeephypothermia,endocardi[s,redos,doublevalves,dualplateletinhibi[onnotwithdrawnlast48hoursetc
• Elec[ve/semielec[vesurgeryonly
INCLUDEDSINCESTARTMIDAPRIL2015
• 65pa[entsenrolledinthestudy• 30pa[entsreceivedplatelettransfusion• Clusterrandomisa[on
THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
Differenceinmul[plateagertransfusionepisode1
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trap adp aspi col ristoh
ChartTitle
warm cold
THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
Plateletcountthefirst24hours
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baseline pretransfusion poshransfusion 24hours
ChartTitle
Serie1 Serie2
THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
CHESTDRAINOUTPUT24HOURS
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Kategori1 Kategori2
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Serie1
THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
AVERAGENUMBEROFPLATELETUNITSUSED
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THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
ADVERSEEFFECTSDUETOTRANSFUSIONOFCOLDPLT`S??
• NOTROMBOEMBOLICEVENTSFIRST24HOURS
THOR - TRAUMA HEMOSTASIS & OXYGENATION RESEARCH NETWORK
THEWAYFORWARD
• ENDTHISSTUDYWHEN20INEACHARM• PROCEEDWITHUPTO14DAYSOFCOLDSTORAGENONAGITATED
• COMPARE1:1:1USINGCOLDSTOREDAPHERESISPLT`SANDCOLDSTOREDWHOLEBLOOD
• STARTUSINGCOLDSTOREDWHOLEBLOODINTHETRAUMAPACKSSTARTINGSEPTEMBER??