BLOOD SUBSTITUTE SAVES TRAUMA PATIENTS
Every year, thousands of accident and trauma victims will bleed to death on the way to the emergency room. A new solution that could change that fate for people across the country.
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This is not the kind of ride anyone expects to take. But thousands a year will have to take this ride.
Devin Price
Paramedic
"Primarily, what we'll see for trauma patients are car accidents, folks who have fallen a great distance, victims of violent shootings, stabbings, assaults."
Paramedic Devin Price gives trauma patients saline intravenously when he gets to the scene. That helps raise the blood pressure.
Devin Price
"Unfortunately, with normal saline, it doesn't replace blood volume and doesn't transport oxygen."
Two elements that are vital for survival. Now, this new blood substitute called polyheme can offer that. Doctor David Hoyt explains polyheme is blood that's been purified to its simplest form.
David Hoyt, M.D.
Trauma Surgeon
University of California, San Diego
San Diego, CA
"Because it has hemoglobin in it, it allows hemoglobin to carry oxygen, just like your own blood does."
Polyheme is currently under study. Since trauma patients can't give consent on the scene, people living where the trial takes place have the opportunity to wear a wristband that excludes them from participating.
David Hoyt, M.D.
"This current product does not seem to have any risk at all, and it's been studied in over hundreds of patients, so we think it's a very safe product."
It's also effective. In a study of 200 patients, 75 percent who received polyheme survived at least 30 days compared to just 35 percent of patients who didn't get it.
Devin Price
"I've only given it once so far. It was great. It had tremendous impact upon the patient's outcome."
Experts say polyheme could save about 10,000 lives each year. And that, after all, is the goal of emergency care.
Because polyheme is a blood product that's purified to such a simple form, there is no need to worry about blood types. The product is universal and will work for people of types of blood.
BACKGROUND: Each year, thousands of accident and trauma victims will die on the way to the nearest emergency room. But a new blood product that could soon be in the ambulance that takes them there could change that fate. Most ground transport ambulances do not carry blood on board because of storage, temperature and compatibility concerns. The current standard of care calls for the use of saline solution in situations where blood is not available (such as at the scene of an accident or in an ambulance). The saline IV compensates for lost blood volume in patients who have sustained significant blood loss. It also helps raise the blood pressure of victims. Lost blood volume, and the corresponding drop in blood pressure, can lead to oxygen and nutrient-starvation in vital organs of the body. Continued lack of tissue perfusion can lead to organ failure and eventually death. Saline solution can be used in place of human blood to increase volume in the bloodstream, but it cannot deliver oxygen in sufficient quantities.
"BLOOD" TO THE RESCUE: Some ambulances across the country will be giving a blood product called PolyHeme to some of their patients rather than saline. PolyHeme is an oxygen-carrying blood substitute made from human blood. Trauma Surgeon David Hoyt, M.D., from the University of California, San Diego, says the product is basically blood that's been purified to its simplest form. PolyHeme is composed of red blood cells that have been extracted from human blood. The hemoglobin protein is then chemically modified so that it can be used in people of all blood types, without the fear of mismatching blood types. Regular blood has a shelf life of about 42 days. PolyHeme can last up to 12 months. It is also highly purified to reduce the risk of viral disease transmission.
STUDY RESULTS: Early studies of PolyHeme are encouraging. One 2002 study of 171 patients shows 75 percent of patients who were given PolyHeme survived at least 30 days, while just 35.5 percent of those who did not receive PolyHeme survived. In January 2004, a nationwide study began in which paramedics would use PolyHeme on trauma patients headed to the ER. The study will enroll 750 patients. No adverse effects of PolyHeme have been seen to date, and researchers say it's extremely safe. Dr. Hoyt says, "This current produce does not seem to have any risk at all and it's been studied in over hundreds of patients. We think it's a very safe product. I would have no problem getting PolyHeme."
THE CONSENT FACTOR: Nearly all clinical studies require a patient's consent to participate. However, when you're injured in an accident, unconscious and bleeding, you can't give consent. To make sure the study is conducted in an ethical way, researchers inform the community through public disclosure. This process informs the public that the study is happening and gives anybody who wants the chance to opt out to do so. To opt out, patients wear an armband that says they do not want to participate in the trial.
Beth Romeril
Study Coordinator
University of California, San Diego
(619) 543-7662
eromeril@ucsd.edu
Copyright © 2004 Ivanhoe Broadcast News, Inc.
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