Transfusion research reduces deaths by 40 percent

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NHS blood donor van Pic: RachelH_

Ground-breaking research by Queen Mary University of London in Mile End, Barts Health NHS Trust and NHS Blood and Transplant has reduced deaths from severe bleeding after major trauma by 40 per cent since 2008.

The new protocol, named Code Red, involves radically changing the traditional approach to resuscitating bleeding patients. Instead of giving large volume of clear fluid, doctors use blood products and clotting agents. This also includes giving blood to patients before they got to hospital.

The study’s lead author, Dr Elaine Cole from Queen Mary University of London said: “Changes in transfusion and resuscitation practice for traumatically injured patients that are rooted in research have led to remarkable improvements in survival.

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Queen Mary College, University of London Pic: Matt Brown

Code Red has been deemed such a success that it is to be adopted across other trauma centres in the country.

Along with reduced deaths, the need for blood transfusions decreased massively. Importantly, those requiring a major transfusion, more than ten units of blood, fell from 68 per cent to 33 per cent.

Common causes of critical bleeding, include: injuries from knife violence, gastrointestinal bleeding, ruptured aortic aneurysm, obstetric haemorrhage, and surgical procedures.

The NHS estimates that each year approximately 2.5 million units of blood are transfused in the United Kingdom.

Co-author Professor Karim Brohi, Consultant Trauma Surgeon at Barts Health NHS Trust, Professor of Trauma Sciences at Queen Mary University of London and Director of the London Trauma System, said: “Over ten years clinical and research trauma teams have worked hand-in-hand to understand what happens in the first few minutes after injury and how we can stop patients bleeding to death.”

The protocol was developed over time as researchers measured the outcomes of 1,169 critically bleeding trauma patients at The Royal London Hospital Major Trauma Centre between 2008-2017.

NHS Blood and Transplant Medical and Research Director Gail Miflin said: “We are delighted to be part of this work and look forward to working more closely with our clinical and academic partners at Barts Health and Queen Mary to further improve outcomes of patients.’’

The research was published in Annals of Surgery and was funded by several bodies including Barts Charity, the National Institute for Health Research, and the European Commission.

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