Intensive Care Medicine

, Volume 29, Issue 3, pp 378–385

DCL-Hb for trauma patients with severe hemorrhagic shock: the European "On-Scene" Multicenter Study

Authors

  • Thoralf Kerner
    • Klinik für Anästhesiologie und Operative Intensivmedizin,Campus Virchow-Klinikum, Charité Humboldt Universität
  • Olaf Ahlers
    • Klinik für Anästhesiologie und Operative Intensivmedizin,Campus Virchow-Klinikum, Charité Humboldt Universität
  • Siegfried Veit
    • Anästhesiologie und IntensivtherapieKrankenhaus im Friedrichshain
  • Bruno Riou
    • Service d'Accueil des Urgences et Département, d'Anesthésie-Réanimation, Groupe hospitalier Pitié-Salpêtrière,Assistance Publique-Hôpitaux de Paris Université Pierre et Marie Curie
  • Michael Saunders
    • Hemoglobin TherapeuticsBaxter Healthcare Corporation
    • Klinik für Anästhesiologie und Operative Intensivmedizin,Campus Virchow-Klinikum, Charité Humboldt Universität
  • for the European DCLHb Trauma Study Group
Original

DOI: 10.1007/s00134-002-1622-x

Cite this article as:
Kerner, T., Ahlers, O., Veit, S. et al. Intensive Care Med (2003) 29: 378. doi:10.1007/s00134-002-1622-x

Abstract

Objective

A major cause of death in patients with severe hemorrhagic shock following trauma is the subsequent occurrence of multiple organ failure due to tissue hypoxia. Early administration of an oxygen carrier may reduce the occurrence of organ failures and improve survival. It may also reduce the need of blood products.

Design and setting

Prospective multicenter study in a university clinic.

Patients

121 patients with severe hemorrhagic shock.

Interventions

Patients were randomly assigned "on-scene" to receive either up to 1000 ml of a 10% diaspirin cross-linked hemoglobin (DCLHb) solution or the study center's standard therapy.

Measurements and results

Demographic and physiological characteristics of the two treatment groups at baseline were comparable. Organ failures and survival rates until day 5 and day 28 showed no significant differences. The sponsor therefore terminated this trial prematurely after an interim evaluation of the data indicated no evidence of efficacy to offset concerns raised about the safety of DCLHb. Median volumes of cumulative blood products administered on 1 (1595 vs. 3716 ml) and 7 days (3139 vs. 4746 ml) after admission were lower in the DCLHb group.

Conclusions

The early application of an oxygen carrier (DCLHb) to patients with severe hemorrhagic shock following trauma had no significant effect on the occurrence of organ failure or on 5- and 28-day survival in this abbreviated trial. However, early infusion of up to 1000 ml DCLHb reduces the need for blood products without changing morbidity or survival.

Keywords

Severe traumaBlood transfusionArtificial oxygen carrierOrgan failure

Copyright information

© Springer-Verlag 2003