By What were the major findings in the crash 2 trial?
Main outcome measures: The primary outcome was death in hospital within 4 weeks of injury, and was described with the following categories: bleeding, vascular occlusion (myocardial infarction, stroke and pulmonary embolism), multiorgan failure, head injury and other.
What year was the Crash 2 trial?
The trial was undertaken in 274 hospitals in 40 countries. The first patient was enrolled in May, 2005….
| Bleeding | |
| Tranexamic acid (n=10 060) | 489 (4·9%) |
| Placebo (n=10 067) | 574 (5·7%) |
| RR (95% CI) | 0·85 (0·76–0·96) |
| p value (two-sided) | 0·0077 |
What is the mechanism of action of tranexamic acid?
Mode of action Tranexamic acid is a synthetic derivative of the amino acid lysine and binds the 5 lysine binding sites on plasminogen. This inhibits plasmin formation and displaces plasminogen from the fibrin surface. It may also directly inhibit plasmin and partially inhibit fibrinogenolysis at higher concentrations.
What is the crash trial?
CRASH is a large simple, placebo-controlled trial of the effects of a 48-hour infusion of corticosteroids on death and on neurological disability, among adults with head injury and some impairment of consciousness.
What is permissive hypotension in trauma?
The concept of “permissive hypotension” refers to managing trauma patients by restricting the amount of fluid resuscitation administered while maintaining blood pressure in the lower than normal range if there is still active bleeding during the acute period of injury [6, 7].
What is a massive transfusion protocol?
“Massive Transfusion Protocol” (MTP) refers to rapid administration of large amounts of blood products (at least 6 units of PRBC) in fixed ratios (usually 1:1:1) for the management of hemorrhagic shock. Only a subset of patients with “massive transfusion” will receive a massive transfusion protocol.
Is there a sequel to the movie Crash?
Crash 2: Still Crashing.
Does tranexamic acid cause thrombosis?
Tranexamic acid is an antifibrinolytic drug. It therefore reduces bleeding but, in certain situations, it may expose patients to a risk of thrombosis. It is used for the treatment of various types of bleeding, including menorrhagia, haematuria, certain surgical procedures and trauma.
What is the purpose of permissive hypotension?
Permissive hypotension is the act of maintaining a blood pressure lower than physiologic levels in a patient that has suffered from hemorrhagic blood loss. The practice is employed in order to maintain adequate vasoconstriction, organ perfusion, and prevent an undesired coagulopathy during initial fluid resuscitation.
What is the triangle of death in surgery?
The death triangle (the lethal triad) It consists of hypothermia, acquired coagulopathy, and acidosis and was defined for the first time by Burch et al [5]. This condition gives rise to the depletion of physiological reserves and to life-threatening consequences (Figure 1).
How much blood is considered a massive transfusion?
Massive transfusion, historically defined as the replacement by transfusion of 10 units of red cells in 24 hours, is a response to massive and uncontrolled hemorrhage.
What was the purpose of the crash 2 trial?
Background: A widely practicable treatment that reduces blood loss after trauma could prevent thousands of premature deaths each year. The CRASH-2 trial aimed to determine the effect of the early administration of tranexamic acid on death and transfusion requirement in bleeding trauma patients.
How many patients were lost in the crash 2 trial?
However, despite the very small percentage of patients lost to follow-up, CRASH-2 is a massive trial. A total of 84 patients were lost. Depending on their outcomes, those lost patients would be enough to change the results of the trial.
When was the update to crash 2 published?
Translated abstracts available in: Chinese, Hindi, and Spanish. An update to the CRASH-2 content was published on March 24, 2011.
Is the CRASH-2 trial underestimating the benefit of TXA?
On the other hand, there is a chance that CRASH-2 underestimates the benefit of TXA. Death due to bleeding only occurred in about 5% of the population, and this is the only disease specific mortality that TXA reduced.