Congratulations to Dr. Robert Gooch, DEM Clinical Assistant Professor, who contributed to the recent publication, Factors in the Initial Resuscitation of Patients With Severe Trauma: The FiiRST-2 Randomized Clinical Trial, in JAMA Network Open.
This study investigates whether fibrinogen concentrate (FC) and prothrombin complex concentrate (PCC) can reduce the use of allogeneic blood products within 24 hours in severely injured trauma patients when compared to frozen plasma (FP). The findings indicate that in a clinical trial involving 137 patients who received massive hemorrhage protocol activation upon admission, there was no significant difference in the use of allogeneic blood products within 24 hours between the FC-PCC group and the FP group.
Publication Title
Factors in the Initial Resuscitation of Patients With Severe Trauma: The FiiRST-2 Randomized Clinical Trial (JAMA Network Open, 2025)
Abstract
Patients experiencing bleeding and coagulopathic trauma often require more blood transfusions and have higher mortality rates. This situation drives research aimed at improving hemostatic strategies. This study examines the use of frozen plasma (FP) or factor concentrates—specifically, fibrinogen concentrate (FC) and prothrombin complex concentrate (PCC)—for replacing clotting factors during the initial resuscitation of trauma patients.
The primary outcome measured was the total number of allogeneic blood products (including red blood cells, FP, and platelets) administered within the first 24 hours. Secondary outcomes included the incidence of thromboembolic events, the duration of stay in the intensive care unit, and overall mortality rates.
“Severely injured trauma patients are at risk of coagulopathy. Initial resuscitation with factor replacement was not superior to plasma, but remains an effective option, especially where plasma is unavailable.” — Dr. Robert Gooch