RETIC Trial: Reversal of Trauma Induced Coagulopathy Using Coagulation Factor Concentrates or Fresh Frozen Plasma
Status:
Terminated
Trial end date:
2016-02-01
Target enrollment:
Participant gender:
Summary
Severe traumatized patients (ISS > 15) admitted to emergency department (ED) University
Hospital Innsbruck with obvious bleeding and/or who are at risk for significant hemorrhage
will be screened by rotational thrombelastometry (ROTEM) assays during ED treatment and
subsequent surgical/radiological interventions for having coagulopathy (T0). If a patient
meets the inclusion criteria (T1) and is recruited for the study, a first study related blood
sample (40mL) will be drawn, and data collected. Subsequently, 100 patients will be
randomized to receive Fibrinogen concentrate and/or Prothrombin complex concentrate and/or
FXIII concentrate for reversal of coagulopathy, while the other 100 patients will receive
fresh frozen plasma (FFP),respectively.
Treatment failure will be registered if bleeding persists and ROTEM parameters do not improve
after two times dosages of study drug. In these cases haemostatic rescue therapy will be
administered. CFC (fibrinogen concentrate and/or PCC, and/or FXIII concentrate) will be
administered to patients randomized to receive FFP and FFP will be administered to patients
of the CFC group.
In cases unresponsive to comprehensive treatment or normal ROTEM combined with diffuse
bleeding, other haemostatic medications can be administered (e.g rFVIIa, DDAVP, VWF/FVIII
concentrate) as judged by the anesthetist in charge. The need and type of any rescue therapy
will be documented and a ROTEM will be performed thereafter.
At admission to ICU (T0 ICU), 24h (T24 ICU) and 48h(T48 ICU) thereafter further study related
blood samples are drawn (40mL each).
The indications for transfusion of red blood cells or platelets, administration of
antifibrinolytics, treatment of acidosis, hypothermia, hypocalcemia and volume replacement
are similar for both groups and treatment is performed according to clinical routine.
Besides coagulation management during ED treatment until 24h on ICU, patient's care is not
influenced by the study and follows clinical routine.