Note: A hodgepodge of trials, added to as I come across them at work, during teaching or whilst preparing pages for this site. Interpretation of trial results is opinion (my own or my teachers’) and is included only as a prompt to read further and not as gospel.
Trauma
Lead to widespread uptake of TXA in major haemorrhage
Death within 4 weeks of traumatic injury was reduced by 9% vs placebo
Survival advantage was seen when first dose given within 3 hours of the time of trauma
Comparison of 1:1 and 1:2 ratios of FFP:RBC in major haemorrhage
No difference in overall mortality.
Comparison of viscoelastic assays versus conventional coag tests to guide management of major trauma haemorrhage.
Approx. 400 patients randomised 1:1
No difference in No. patients alive at 24 hours / free of massive haemorrhage at 24 hrs / alive at 28 days
sickle
Rate of post-operative sickle cell acute chest crisis was reduced by pre-op red cell transfusion for patient undergoing low to medium risk surgery. Only a small study but significant difference seen.
ACS occurred in 27% of untransfused, compared to 3% of transfused patients.
Platelets
TRAP 1997 (Trial to Reduce Alloimmunisation to Platelets study)
530 patients receiving induction chemo for AML
Leucocyte depleted vs Non-depleted platelet transfusions
Leucocyte depleted - 18% alloimmunised and 3% refractoriness due to alloimmunisation
Non-depleted - 45% alloimmunised and 13% refractoriness due to alloimmunisation