RePHILL

RePHILL-LogoRePHILL (Resuscitation with Pre-Hospital Blood Products) is a multi-centre randomised controlled trial of pre-hospital blood product administration versus standard care for traumatic haemorrhage, funded by the National Institute for Health Research (NIHR) Efficacy & Mechanism Evaluation Programme (EME; project number 14/152/14). The trial will test the hypothesis that Pre-Hospital Blood Products (PHBP) resuscitation with up to two units each of packed red blood cells (PRBC) and lyophilised plasma (LyoPlas N-w) will improve tissue perfusion (as measured by lactate clearance) and reduce mortality in trauma patients with haemorrhagic shock compared to the current standard practice of crystalloid (normal saline) resuscitation.

RePHILL included an internal pilot phase, where the trial opened in the West Midlands. The trial then rolled out to and the East Midlands and East Anglia.

Air ambulances currently involved are: Midlands Air Ambulance (MAA), The Air Ambulance Service (TAAS), Mid Anglia General Practioner Accident Service (MAGPAS) and East Anglian Air Ambulance (EAAA). These are supplied by the following blood banks:  New Cross Hospital, University Hospitals Coventry and Warwickshire, Cambridge University Hospitals and Norfolk & Norwich University Hospital. RePHILL patients are then transferred to one of several receiving emergency departments at the Queen Elizabeth Hospital (Birmingham), Walsgrave Hospital (Coventry), Addenbrooke's Hospital (Cambridge), Norfolk and Norwich Hospital, Royal Stoke University Hospital and the Queen's Medical Centre (Nottingham).

 

Design

A multi-centre randomised controlled trial of pre-hospital blood product administration versus standard care for traumatic haemorrhage.

Aim of Study

The principle objective of this trial is to investigate the clinical effectiveness of Pre-Hospital Blood Products (PHBP) resuscitation compared to the current standard care of restricted crystalloid based resuscitation in participants suffering from major traumatic haemorrhage.

Setting

 Pre Hospital Emergency Medicine (PHEM) and Major Trauma Centres (MTC)

Target Population

Patients believed to be over the age of 16 who have sustained a traumatic injury resulting in haemorrhage.

Intervention

Participants will be randomised between crystalloid resuscitation (up to four 250ml bags of 0.9% sodium chloride) or Pre-Hospital Blood Products resuscitation (up to two units of packed red blood cells and two units of LyoPlas).

The views expressed are those of the authors and not necessarily those of the NHS, NIHR or the Department of Health.

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