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Completed Research

Trauma Research Center

The Trauma Research Center is a multi-institutional, multidisciplinary research unit supported by the National Institute of General Medical Sciences (NIGMS) of the United States National Institutes of Health (NIH). The Trauma Research Program is an extensive, collaborative effort that draws upon several related sources all located within the Texas Medical Center in an effort to improve trauma medicine through translational research efforts. The Center's research focus is to study traumatic brain injury, resuscitation, hemorrhagic shock, and organ injury/dysfunction.

Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR)
PROPPR was a randomized trial to evaluate ratios, massive transfusion patients receive either 1:1:1 (higher ratio) or a 1:1:2 (lower ratio) RBC:Plasma: Platelet with primary outcome of survival, and also complications and length of hospital stay.
Conclusions & Relevance – Among patients with severe trauma and major bleeding, early administration of plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio did not result in significant differences in mortality at 24 hours or at 30 days. However, more patients in the 1:1:1 group achieved hemostasis and fewer experienced death due to exsanguination by 24 hours. Even though there was an increased use of plasma and platelets transfused in the 1:1:1 group, no other safety differences were identified between the 2 groups.
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial
Prospective, Observational, Multi-Center Major Trauma Transfusion Study (PROMMTT)
Objective – To relate in-hospital mortality to early transfusion of plasma and/or platelets to time-varying plasma:red blood cell (RBC) and platelet:RBC ratios.
Conclusions – Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission.  Among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or platelet ratios.
The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks
Prehospital Resuscitation on Helicopter Study  (PROHS)
Background – Earlier us of in-hospital plasma platelets and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). The hypothesis of this study was that patients with severe traumatic injuries evacuated to level 1 trauma centers on air ambulances who received prehospital red blood cells and/or plasma would have lower in-hospital mortality compared to patients transferred by air ambulance who received only crystalloid.
Conclusion - Because of the unexpected imbalance in systolic blood pressure, Glasgow Coma Scale (GCS) and injury severity score (ISS) between systems with and without blood products on helicopters, matching was limited and the results of this study are inconclusive. With few units transfused to each patient and small outcome differences between groups, it is likely large, multicenter, randomized studies will be required to detect survival differences in this important population.
Multicenter observational prehospital resuscitation on helicopter study