Bellevue physician to lead national trauma study

University of Washington researchers are launching a new study this fall, which they hope helps to determine which combination of blood products provides the best outcomes for trauma patients requiring extensive transfusions.

Led by Bellevue's Dr. Eileen Bulger, UW professor of surgery and chief of trauma at Harborview Medical Center, the study will be conducted at 12 Level I trauma centers across the United States and Canada over the next two years. The study will begin at Harborview toward the end of September or the beginning of October.

A transplant from the East Coast who moved to Seattle for her residency, Bulger has been working and conducting research in the Pacific Northwest since 1992. Before taking the position as chief of trauma on August 1, Bulger worked previously as the associate director, and director of emergency at Harborview.

Entitled the Pragmatic Randomized Optimal Plasma Platelet Ratio (PROPPR), the study will aim to find out the optimal combination of blood products (red cells, plasma and platelets) to give to people who are rapidly bleeding.

Because this study is being conducted on patients who have suffered severe trauma and are unlikely to be conscious, informed consent will most likely be impossible to obtain.

"Trauma is something that happens out of the blue, it's very unexpected," Bulger said. "You don't wake up and think, 'I'm going to get hit by a car today.'"

As such, the UW Institutional Review Board (IRB) that oversees all clinical studies has granted the study a waiver of consent. All blood products used for the study will be the standard FDA licensed blood products patients would normally receive for transfusions.

Interest in this study came about as the result of research done by Col. John Holcomb, a top Army surgeon who has been collecting data on the injuries coming out of the conflicts in Iraq and Afghanistan.

Bulger says the data collected by Holcomb suggests that patients given different ratios of blood products showed different results. The new study is meant to record results in real time, versus looking back after an extended period of time.

Bulger, whose studies began in general surgery, has since had extensive experience with car wrecks and gunshot wounds. However, she says, the leading source of trauma, nationwide, is injury to the elderly from falling. She said the PROPPR study is looking to answer one of the major questions in trauma surgery right now.

The blood products used in this study are the same products being used in the field. There is nothing new being introduced. Rather, the ratio is being controlled.

Study leaders will be conducting community consultation meetings to provide the general public with more information about the study. Anyone who does not wish to be involved in this study can contact the study nurse at 206-744-7724 and ask for a red silicone wristband with “NO PROPPR” indicated, this will ensure that the patient will not be screened or enrolled into this study.

Contact Bellevue Reporter Staff Writer Keegan Prosser at kprosser@bellevuereporter.com or 425-453-4602.

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