The Deployed Hemostatic Emergency Resuscitation of Traumatic Exsanguinating Shock (Deployed HEROES) Study
Abstract
It is estimated that 90 of potentially survivable combat deaths were due to hemorrhage, thereby making hemorrhage control strategies of paramount importance to improving patient outcomes. There were over 350,000 units of blood products transfused during the conflicts in the Middle East, greater than 10,700 of which were fresh whole blood (FWB). Throughout the course of the conflicts, the recommendations for hemorrhage resuscitation have evolved and interim studies have associated the changes with improved outcomes. Use of aggressive hemorrhage control and blood transfusion to reduce morbidity and mortality is prioritized in the Joint Trauma Systems Tactical Combat Casualty Care Guidelines as well as in the Damage Control Resuscitation Clinical Practice Guideline. The full study dataset was created in HIPAA compliant database (n=19,060). A total of 2,983 records were abstracted for phase I of the Deployed HEROES project. Of those, we included patients that were, 1. Battle injured, 2. had an injury time available, and 3. received whole blood (at least 1 unit). Each record was imported into REDCap. An interim analysis was complete and offered reportable insight to blood delivery practices. However, the significant undertaking of a full-spectrum analysis of transfusion strategies and associated outcomes has not yet been completed. Follow-on funding will be required to complete the full spectrum analysis. There remains a need for this analysis because despite the changes to the clinical practice guidelines and the evolution in transfusion practice to include the introduction of low titer type-O whole blood (LTOWB) into U.S. Central Command, there has been no comprehensive comparative effectiveness study of the advances in resuscitation strategies initiated during the conflicts in the Middle East. Additionally, many far forward surgical teams are unable to perform a balanced resuscitation due to multiple logistical, clinical, operational, and doctrinal challenges.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 30, 2023
- Accession Number
- AD1228757
Entities
People
- Amanda M. Staudt
- Jennifer D. Trevino
- Jennifer M. Gurney
Organizations
- 59th Medical Wing