• Association of Prehospital Plasma with Survival in Patients With Traumatic Brain Injury : A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial

    • Several studies have indicated that early treatment with plasma may benefit trauma patients.
    • Early administration may lessen endothelial damage and inflammation, reducing the effects of shock and secondary brain injury. Plasma may also limit excessive crystalloid use and its adverse effects. 
    • Sub-analysis of traumatic brain injury (TBI) patients enrolled in the PAMPer (Prehospital Air Medical Plasma) trial
    • Regression model developed evaluating TBI patients
    • PAMPer was a pragmatic, phase 3, multicentral, cluster-randomized trial.
      • Subjects were injured patients at risk for hemorrhagic shock during air transport to a trauma center
      • Six US sites with nine level 1 trauma centers
      • Patients randomized to receive standard fluid resuscitation or two units of thawed plasma
      • 501 patients analyzed; 203 received plasma
    • 166 TBI patients: 43 years old, 75% men, all sustained blunt trauma
    • Median Injury Severity Score (ISS) 29, and over half had a subdural hematoma or hemorrhage
    • Patients receiving prehospital plasma received less crystalloid fluid, vasopressors, and packed red cells in first 24 hours of hospitalization.
    • Patients receiving prehospital plasma had lower unadjusted 24-hour and 30-day mortality (16% vs 35.9% and 35.1% vs 55.4%).
    • This association remained significant after accounting for multiple confounding variables.
    • The survival benefit did not extend to patients who were transferred from an outside hospital before receiving plasma.
    • Despite these benefits, patients receiving plasma had a greater incidence of multiple organ failure, longer intensive care unit stays, and longer hospital stays.




We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site here. Privacy Policy