Faster is Better in Hemorrhage Control

Minutes Matter.
Time to hemorrhage control is critical when minutes mean blood loss.

Time to hemorrhage control is critical when minutes mean blood loss.

Every effort should be made to decrease the time to administration of the first blood products.1

Each minute of delay between the activation on an MTP and the arrival of the first blood products results in a 5% increase in the odds of mortality.1

Timely delivery of blood products is an important metric, similar to “door-to-balloon” time.1

Massive Transfusion Protocols (MTP) improve hemorrhage outcomes by delivering blood products quickly, but they lack critical components from the start.

In today’s MTP’s, sources of clotting factors (e.g., cryoprecipitated Antihemophilic Factor (cryo AHF)) for the treatment of coagulopathy in hemorrhage often arrive too late to be medically efficacious.2,3

In >75% of U.S. exsanguination cases,
cryo AHF arrives too late to be medically efficacious.2,3*

Availability of cryo AHF is delayed due to the time required to thaw, which is typically performed on demand as a result of its short 4-6 hour shelf life post-thaw, and therefore is established into later rounds of MTPs.3,4

Improving fibrinogen levels earlier may help close the mortality gap7,8

Early delivery of fibrinogen and other vital clotting factors add the clotting strength needed to achieve stable clot formation and restore hemostasis.5,6

CRYOSTAT-1, a feasibility clinical trial requiring transfusion of cryoprecipitated-AHF as a source of fibrinogen within 90 minutes of hospital admission, showed a trend towards improved survival in the patient group receiving cryoprecipitated AHF earlier. While mean time to receipt was still one hour, and none received it earlier than 30 minutes, a vastly larger clinical trial, CRYOSTAT-2 is currently recruiting with the primary end point of answering whether the addition of early cryoprecipitate to the current standard of care Major Hemorrhage Protocol (MHP) improves survival from major trauma hemorrhage.9

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