Not much has changed since World War I when it comes to quickly replacing blood loss in seriously injured patients. The standard treatment at the scene of injury is to inject saline solution (salt water) into the patient's blood stream. The fluid helps restore blood pressure, but it does not carry oxygen, which is one of the most important things our blood does. A constant supply of oxygen is needed to keep our hearts, brains and other organs functioning.
Unfortunately, blood does not travel well. Ambulances cannot carry blood to accident victims at the scene of injury. Blood must be refrigerated, and even when kept cool, it has a short shelf life. A blood transfusion must be matched to the patient's blood type. These are capabilities ambulances do not have. As a result, trauma victims sometimes wait up to an hour for blood typing and cross-matching to be completed at the hospital.
Nearly one in five trauma patients die from their injuries, and loss of blood is a major contributor to those deaths. Loyola University Health System (Loyola) is part of a nationwide clinical trial to help reduce deaths from traumatic injuries. We are one of only 20 Level I trauma centers in the trial nationwide and the only one in Illinois that is testing PolyHeme®, a blood substitute manufactured by Northfield Laboratories in Evanston, Ill. The product was tested extensively and found to be safe and effective in earlier studies. We are participating in the final phase of testing before the product may be approved for use nationwide.
An effective, artificial blood substitute may prove to be the most important development in trauma care in this century. Unlike saline, the blood substitute delivers oxygen, and unlike blood, it is immediately available in emergency situations because it is compatible with all blood types and has an extended shelf life of more than 12 months.
Loyola will use the blood substitute for some patients on its LIFESTAR® aeromedical unit and in Berwyn, Hillside and Northlake, which participate in Loyola's Emergency Medical Services network. These communities have extensive experience with trauma because of their proximity to major highways. Loyola's LIFESTAR staff will administer the blood substitute to victims of motor vehicle crashes on major Chicago-area highways and in other trauma situations.
Loyola plans to enroll about 20 severely injured adult patients in the study (10 will receive the blood substitute, and 10 will receive saline). About 700 patients will be enrolled in the study at all sites nationwide.
Since February, Loyola has been engaged in a dialogue with surrounding communities about this important clinical trial. Hospital representatives have met with community leaders, invited the public to open forums, placed public notices in community newspapers, asked for feedback on Loyola's Web site, and distributed flyers in schools, churches, grocery stores and public health centers. Overall, the feedback from all sources has been positive.
These outreach efforts were necessary because of the nature of this study. People who are severely injured and bleeding typically are not capable of understanding and consenting to participate in a clinical trial, so we have asked for broad community feedback and given people the opportunity to opt out of the trial if they choose.
Patient consent will be sought whenever possible at the time of injury. Of course, if a patient or the patient's family objects, he or she will not receive the blood substitute. People who do not want to receive the blood substitute if they are traumatically injured can obtain a special wrist band by sending an e-mail to bloodsubstitute@lumc.edu or calling the hotline (708) 327-2452. Visit Loyola's Web site at www.luhs.org/bloodsubstitute for more detailed information about the study.
We greatly appreciate the feedback and enthusiastic support we have received from the community regarding this study. Within a few years, this blood substitute may become the new standard of care at trauma centers throughout the country. The communities surrounding Loyola University Medical Center will play an important role in the process. The result may be a groundbreaking development in trauma care that results in countless lives being saved.
Richard L. Gamelli, M.D.
Professor and Chairman, Department of Surgery,
Loyola University Chicago Stritch School of Medicine
Mark Cichon, D.O.
Associate Professor of Surgery,
Loyola University Chicago Stritch School of Medicine
Director, Emergency Medical Services,
Loyola University Health System
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