6/29/23, 1:34 AM PAMPer Pathway Feedback Search Clinical Topics Home Studies PAMPer PAMPer Disease Traumatic hemorrhage Trial question What is the role of prehospital administration of thawed plasma during air medical transport in trauma patients at risk for hemorrhagic shock? Study design Multi-center Open label RCT Population Characteristics of study participants 27.0% female N = 501 73.0% male 501 patients (137 female, 364 male) Inclusion criteria: injured patients who were at risk for hemorrhagic shock during air medical transport to a trauma center Key exclusion criteria: older than 90 years of age or younger than 18 years of age, non- establishment of intravenous or intraosseous access, cervical cord injury, penetrating brain injury, injury due to isolated drowning, or hanging Interventions N=230 plasma (administration of 2 units of thawed plasma initiated in the prehospital setting by the air transport team) https://web.pathway.md/studies/recDFloYgWGrKF2Ef 1/2 6/29/23, 1:34 AM PAMPer Pathway N=271 standard-care (resuscitation with the infusion of a crystalloid solution as the primary resuscitative fluid during the flight) Primary outcome Death at 30 days 33.0 % 33 24.8 % 23.2 16.5 % Significant decrease 8.3 % NNT = 10 0.0 % Plasma Standard-care Significant decrease in death at 30 days (23.2% vs. 33%; ARD -9.8, 95% CI -18.6 to -1) Secondary outcomes Significant decrease in death within 24 hours (13.9% vs. 22.1%; ARD -8.2, 95% CI -14.9 to -1.6) Significant decrease in death in the hospital (22.2% vs. 32.5%; ARD -10.3, 95% CI -18 to -2.6) No significant difference in multiorgan failure (63% vs. 57.6%; AD 5.4%, 95% CI -3.1 to 14.1) Safety outcomes No significant differences in acute lung injury-ARDS, nosocomial infection, allergic reaction or transfusion-related reaction. Significant difference in prothrombin-time ratio (1.2 vs. 1.3). Conclusion In injured patients who were at risk for hemorrhagic shock during air medical transport to a trauma center, plasma was superior to standard-care with respect to death at 30 days. Reference Jason L Sperry, Francis X Guyette, Joshua B Brown et al. Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. N Engl J Med. 2018 Jul 26;379(4):315-326. Open reference URL https://web.pathway.md/studies/recDFloYgWGrKF2Ef 2/2