Trial reportThe New England journal of medicine2018
Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock.
3 registry-linked trialsAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
In one paragraph
Trial report in The New England journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 307 papers, 8 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
307citing papers in PubMed, 8 pooled it
61.1field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prehospital Air Medical Plasma (PAMPer) Phase III Multicenter, Prospective, Randomized, Open-label, Interventional Trial A Four Year Multicenter Open Label Randomized Trial
Evaluation Of Efficacy Of COVID-19 Convalescent Plasma Versus Standard Plasma In The Early Care Of COVID-19 Patients Hospitalized Outside Intensive Care Units.
How Many Patients Suffering Major Trauma Would be Eligible for a Pre-hospital Transfusion: A Multicentre Retrospective Study.
Who cites it
307 citing papers in PubMed, 8 syntheses or guidelines pooled it, 855 citations in OpenAlex.
- Prehospital plasma transfusion versus standard of care following traumatic injury: a review of the systematic reviews and a meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Prehospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025Pooled it
- The efficacy and safety of pre-hospital plasma in patients at risk for hemorrhagic shock: an updated systematic review and meta-analysis of randomized controlled trials.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Hypocalcaemia upon arrival (HUA) in trauma patients who did and did not receive prehospital blood products: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Heterogeneity in defining multiple trauma: a systematic review of randomized controlled trials.Critical care (London, England) · 2023Pooled it
- Definitions of massive transfusion in adults with critical bleeding: a systematic review.Critical care (London, England) · 2023Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Next generation spray-dried on-demand plasma: A multicenter, randomized, dose-escalation, first-in-human safety study.Transfusion · 2026Trial
- Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage.The New England journal of medicine · 2026Trial
- Bayesian Statistics to Reanalyze Data From the STAAMP Trial.JAMA network open · 2026Trial
- High ratio of plasma to red cells in contemporary resuscitation of haemorrhagic shock after trauma: a secondary analysis of the PATCH-trauma trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Trial
- Pragmatic O-Positive Whole-blood RandoMizaTion in male trauma Patients (POWeR-MTP).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Trial
- Pre-hospital freeze-dried plasma for critical bleeding after trauma: A pilot randomized controlled trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Trial
- Optimal Prehospital Crystalloid Resuscitation Volume in Trauma Patients at Risk for Hemorrhagic Shock.Journal of the American College of Surgeons · 2023Trial
- Use of Bayesian Statistics to Reanalyze Data From the Pragmatic Randomized Optimal Platelet and Plasma Ratios Trial.JAMA network open · 2023Trial
- Trial
- Prehospital Lyophilized Plasma Transfusion for Trauma-Induced Coagulopathy in Patients at Risk for Hemorrhagic Shock: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Prehospital synergy: Tranexamic acid and blood transfusion in patients at risk for hemorrhage.The journal of trauma and acute care surgery · 2022Trial
- Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial.The Lancet. Haematology · 2022Trial
247 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 9 institutions in 1 country.
Jason L SperryFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Francis X GuyetteFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Joshua B BrownFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Mark H YazerFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Darrell J TriulziFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Barbara J Early-YoungFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Peter W AdamsFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Brian J DaleyFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Richard S MillerFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Brian G HarbrechtFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Jeffrey A ClaridgeFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Herb A PhelanFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
William R WithamFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
A Tyler PutnamFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Therese M DuaneFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Louis H AlarconFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Clifton W CallawayFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Brian S ZuckerbraunFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Matthew D NealFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Matthew R RosengartFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Raquel M ForsytheFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Timothy R BilliarFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Donald M YealyFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Andrew B PeitzmanFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
Mazen S ZenatiFrom the Division of Trauma and General Surgery, Department of Surgery (J.L.S., J.B.B., L.H.A., B.S.Z., M.D.N., M.R.R., R.M.F., T.R.B., A.B.P., M.S.Z.), and the Departments of Emergency Medicine (F.X.G., C.W.C., D.M.Y.) and Critical Care Medicine (B.J.E.-Y., P.W.A.), University of Pittsburgh Medical Center, and the Department of Pathology, University of Pittsburgh and Institute for Transfusion Medicine (M.H.Y., D.J.T.), Pittsburgh, and University of Pittsburgh Medical Center, Altoona Hospital, Altoona (A.T.P.) - all in Pennsylvania; the Department of Surgery, University of Tennessee Health Science Center, Knoxville (B.J.D.), and the Department of Surgery, Vanderbilt University Medical Center, Nashville (R.S.M.) - both in Tennessee; the Department of Surgery, University of Louisville, Louisville, KY (B.G.H.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (J.A.C.); and the Department of Surgery, University of Texas Southwestern, Parkland Memorial Hospital, Dallas (H.A.P.) and Texas Health Harris Methodist Hospital (W.R.W.) and the John Peter Smith Health Network (T.M.D.), Fort Worth - all in Texas.
PAMPer Study Group
University of Pittsburgh Medical Center · USUniversity of Pittsburgh · USHealth Net · USMetroHealth Medical Center · USParkland Memorial Hospital · USTexas Health Harris Methodist Hospital Fort Worth · USUniversity of Louisville · USUniversity of Tennessee Health Science Center · USVanderbilt University Medical Center · US
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting.
methodsTo determine the efficacy and safety of prehospital administration of thawed plasma in injured patients who are at risk for hemorrhagic shock, we conducted a pragmatic, multicenter, cluster-randomized, phase 3 superiority trial that compared the administration of thawed plasma with standard-care resuscitation during air medical transport. The primary outcome was mortality at 30 days.
resultsA total of 501 patients were evaluated: 230 patients received plasma (plasma group) and 271 received standard-care resuscitation (standard-care group). Mortality at 30 days was significantly lower in the plasma group than in the standard-care group (23.2% vs. 33.0%; difference, -9.8 percentage points; 95% confidence interval, -18.6 to -1.0%; P=0.03). A similar treatment effect was observed across nine prespecified subgroups (heterogeneity chi-square test, 12.21; P=0.79). Kaplan-Meier curves showed an early separation of the two treatment groups that began 3 hours after randomization and persisted until 30 days after randomization (log-rank chi-square test, 5.70; P=0.02). The median prothrombin-time ratio was lower in the plasma group than in the standard-care group (1.2 [interquartile range, 1.1 to 1.4] vs. 1.3 [interquartile range, 1.1 to 1.6], P<0.001) after the patients' arrival at the trauma center. No significant differences between the two groups were noted with respect to multiorgan failure, acute lung injury-acute respiratory distress syndrome, nosocomial infections, or allergic or transfusion-related reactions.
conclusionsIn injured patients at risk for hemorrhagic shock, the prehospital administration of thawed plasma was safe and resulted in lower 30-day mortality and a lower median prothrombin-time ratio than standard-care resuscitation. (Funded by the U.S. Army Medical Research and Materiel Command; PAMPer ClinicalTrials.gov number, NCT01818427 .).
Indexed as
Blood Component TransfusionPlasmaAdultAir AmbulancesEmergency Medical ServicesFemaleHumansInjury Severity ScoreMaleMiddle AgedProthrombin TimeResuscitationShock, HemorrhagicWounds and Injuries
Identifiers
What OpenQuestion holds
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.