Will blood platelet transfusions help stop brain bleeding and fend off neurologic damage caused by traumatic head injury in patients taking aspirin or Plavix?
Christiana Care Health System’s Level 1 trauma center team leader Mark Cipolle, M.D., Ph.D., FACS, FCCM, section chief of Trauma and Critical Care Surgery, received a grant to study outcomes for trauma patients receiving antiplatelet therapy, which includes an ever-increasing number of people prescribed aspirin and Plavix (clopidogrel) to prevent strokes and heart attacks. Emergency Medicine research staff, with Christy Poole, RN, BSN, CCRC as the study leader, are coordinating the project.
This is the first randomized, controlled trial of platelet transfusion for traumatic intracranial hemorrhage.
The National Trauma Institute approved the grant to start enrolling patients in June after a two-year application process involving Christiana Care and the U.S. Department of Defense, a major supporter of the pilot research project.
At Christiana Care there are about 4,000 trauma admissions a year, and the most common reason for admission among those patients is traumatic brain injury, said Dr. Cipolle. The study will involve patients with intracranial hemorrhaging who are known to be receiving antiplatelet therapy. The study aims to learn whether a platelet transfusion will counteract the increased risk of bleeding—essentially overwhelming the effects of the antiplatelet therapy.
Dr. Cipolle said the primary outcome will be the change in the extent of hemorrhage, measured by CT scan upon the patient’s admission, and again after 24 hours.
To enroll in the study, the patient, or someone with the proper authority, must sign a consent form, and there must be no circumstances that would preclude participation, such as other major traumatic injury or end-stage renal disease.