TOWAR Study Aims to Improve Mortality Rates for Trauma Patients
By: Taylor Andres
Researchers at the University of Pittsburgh are leading the Type O Whole blood and assessment of AGE during prehospital Resuscitation (TOWAR) Trial in an effort to better understand the intricacies of giving whole blood— blood that is not separated into its components— to trauma patients while they are in an ambulance on the way to the hospital.
Dr. Jason Sperry
“When someone donates blood, typically it gets separated it into parts—red cells, plasma, platelets—for storage and the parts can be used individually. But when someone is bleeding, they’re losing all of these parts. Trauma research has shown that if you put all of these parts back together again it can be beneficial to trauma patients or patients at risk of bleeding,” explained Dr. Jason Sperry, a professor of surgery at Pitt and UPMC trauma surgeon.
The whole blood used in the TOWAR study is low titer blood, meaning it contains low levels of antibodies and can be transfused to people of various blood types. Giving whole blood transfusions to trauma patients before they even arrive at the hospital could potentially provide better outcomes and reduce the chance of mortality.
Dr. Frank Guyette
The multi-center trial will begin between late 2021 and early 2022, and is funded by the U.S. Department of Defense, which plans to use the findings of the study to better inform prehospital trauma care for soldiers injured in the field. Principal investigators of the study include Sperry, Dr. Frank Guyette, associate professor of emergency medicine at Pitt, and Dr. Stephen Wisniewski, professor of epidemiology and vice provost for budget and analytics in the Office of the Provost at the Pitt.
“To have whole blood or blood products out in the field, or in remote environments like Iraq or Afghanistan, is very difficult because it is considered expired after a certain point. So, we also want to know more about its shelf life and whether younger versus older whole blood makes a difference or is more safe and effective for trauma patients,” said Sperry.
Dr. Stephen Wisniewski
The purpose of the trial is to answer three key questions:
• Does giving trauma patients whole blood in a prehospital environment improve survival outcomes at 30 days when compared to plasma, red blood cells or nothing at all?
• Does the age of whole blood impact patient survival rates?
• Does administering whole blood provide overall benefit to patients upon evaluation and arrival to the hospital?
The four-year study will use randomly selected trauma patients enrolled from emergency calls, but patients will be able to opt out of the trial in advance by calling 1-800-664-0557.
“The results of this study have the potential to change the way prehospital trauma care is provided,” said Sperry. “If we can determine that whole blood is safe and effective for trauma patients, we can improve the outcomes of these patients even before they arrive at the hospital.”
