The conclusion of a major NHSBT led trial now being published in the world’s leading health journal.
The prestigious New England Journal of Medicine (NEJM) has published the results of an NHS Blood and Transplant (NHSBT) led trial of 'whole blood' transfusions.
The ground-breaking trial was carried out thanks to funding and support from 10 Air Ambulance services in England and Defence Medical Services.
Half of the patients in the study with major traumatic haemorrhage received whole blood – blood as it comes from a donor's arm, containing red blood cell, platelets and plasma – instead of the usual mix of different individual units of red blood cells and plasma.
The results did not show an improvement in survival, but the research – which saw nearly 1,000 people randomised into the trial over 2 years - provided vital evidence in an area of growing interest.
Whole blood transfusion has recently gained favour in trauma care, partly due to military experience in Afghanistan. However data from large clinical trials has been lacking - until now. Whole blood has been of particular interest to Air Ambulance teams because it is easier to transport and transfuse a single product than several products. Air ambulance charities regularly attend patients with life-threatening bleeding following serious injury and survey found 82% said whole blood would be their preferred component.
The trial also evaluated the cost-effectiveness of whole blood for the NHS. These results will be available soon. Taken together, the clinical findings and cost effectiveness findings will help build a more complete understanding of the role of whole blood in clinical practice.
Who took part in the trial?
SWIFT was sponsored by the NHSBT and delivered by the NHSBT Clinical Trials Unit.
The full list of air ambulance charities who contributed to SWIFT is:
- Air Ambulance Kent Surrey Sussex
- Dorset and Somerset Air Ambulance
- Essex and Herts Air Ambulance
- Great North Air Ambulance
- Great Western Air Ambulance
- Hampshire and Isle of Wight Air Ambulance
- London's Air Ambulance
- Magpas Air Ambulance
- North West Air Ambulance
- Thames Valley Air Ambulance
Professor Laura Green, co-chief investigator for SWIFT and Associate Medical Director for Research and Development at NHS Blood and Transplant, said:
"The contribution of everyone involved in delivering the trial will help guide the future care of people experiencing traumatic, life-threatening bleeds.
"The trial did not show a benefit from whole blood but in providing that answer it will help us improve trauma care. We are extremely grateful to the blood donors, patients, and everyone involved in delivering the trial — including the manufacturing team at NHS Blood and Transplant, air ambulance organisations, hospital teams, academic institutions, and the Defence Medical Services — for working together to drive innovation and research that benefits seriously ill patients."
Professor Jason Smith, co-chief investigator, and Medical Director and Head of Research and Clinical Innovation at the Defence Medical Services said:
"Haemorrhage is a leading cause of pre-hospital deaths, and the SWiFT trial provides another piece of the complex jigsaw that will inform how best to deliver emergency transfusion to those with life-threatening bleeding. My thanks to all those patients, clinical and laboratory staff and air ambulance crews who took part in the study and enabled us to complete what will be a landmark clinical trial."
Lindsay Boswell, Interim CEO of Air Ambulances UK, said:
"The publication of the SWiFT trial in the New England Journal of Medicine marks an important moment for pre-hospital emergency medicine in the UK. Air ambulance charities are committed to continual improvement in trauma care."
Find the full research paper on the New England Journal of Medicine website.