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Hi Everyone,
Whole blood, freeze dried plasma, refrigerated or frozen platelets….
On Oct 31st – Nov 3 Graeme, Emelyn and I attended the THOR – THUNDER conference hosted here in Perth at the Rendezvous Hotel in Scarborough.
Who is THOR? In their own words:
The THOR (trauma haemostasis oxygenation resuscitation) organization is a resuscitation and blood network, originating in Norway a decade ago, and now boasting global reach. It has built an avid following of both civilian and military resuscitation clinicians and scientists, covering both pre-hospital and hospital management of critically unwell patients.
The THOR vision is to improve outcomes from traumatic haemorrhagic shock by optimising the acute phase of resuscitation. The mission is to develop and implement the best practices for haemorrhagic shock resuscitation from pre-hospital care right through to the completion of the acute phase of hospital resuscitation.
Thor group website: Trauma Hemostasis and Oxygenation Research Network (rdcr.org)
We sat down to reflect on the different topics that were presented at this fascinating conference. A big shout out to Tania Rogerson for organising such an amazing bunch of speakers. It was great to hear how resuscitation of major haemorrhage is done in other parts of the globe and to be educated about some different resuscitation products that are not available here in Australia.
If you also want to hear a great deep dive into the scientific evidence base for the management of massive haemorrhage then I highly recommend listening to Casey Parker and Justin Morgenstein discussing this topic here (thanks for a great balanced summary of the evidence):
Massive Haemorrhage: Science and Practice – Broome Docs – Nov 2023
Massive hemorrhage: a very deep dive – First10EM – Nov 2023
References
Evaluation of freeze dried plasma for use in NSW – https://aci.health.nsw.gov.au/networks/trauma/resources/freeze-dried-plasma
There has even been a pilot study comparing whole blood for use in accrete spectrum surgery in San Antonio:
The Use of Whole Blood Transfusion in Trauma – Curr Anesthesiol Rep Jan 2022
Warming Up to Cold-stored Platelets Anesthesiology December 2020, Vol. 133, 1161–1163.
2 thoughts on “122 Reflections on the THOR THUNDER conference with Graeme and Emelyn”
Hi Roger
Quick note on the use of prehospital plasma. You mentioned the PAMPEr trial…. Which was “positive” But there was more recently the RePHIll trial which was not positive (aka negative)
So I think we are still at equipoise on this product
I did a deep dive on this with the SGeM https://thesgem.com/2022/06/sgem369-romeo-is-bleeding-does-he-need-a-rephill/
Thanks Casey,
My memory isn’t always reliable but the speakers at the conference did mention it briefly – I think one of the comments was that the Pamper trial involved much longer transport distances and times and that might explain why it did find a benefit whereas this trial didn’t. It certainly appears that a number of NATO military medical services have embraced lyophilised plasma and that the use of crystalloids is considered blasphemous! Thanks again to you and Justin for your great podcast summarising all the evidence in the literature around the different strategies that exist for managing hemaorrhagic shock!