Investigations into Cold Stored Platelets for Pre-Hospital Emergency Resuscitation

End of project summary

Main Messages

Summary

Platelets, the cells within the blood that help form clots and stop bleeding, are used to treat major bleeding within hospitals. However, platelets are challenging to store and transport, as they currently need to be constantly shaken and kept warm (20-24^oC). They are therefore not available for transfusion before a patient reaches hospital, unlike red cells which are already carried in some emergency vehicles.

Recent research has found that it is possible to make Cold Stored Platelets (CSP), which are platelets stored at 4 to 6 degrees Celsius - about the same temperature as a food fridge. The CSP are thought to be better at forming clots and stopping bleeding, even though they don't last as long in the body as the standard platelets. The CSP do not need to be shaken, making them easier to store This opens the possibility of CSP being carried alongside red cell units in emergency vehicles. 

This study compared the quality of CSP stored in the transport containers used to carry red cell units versus CSP stored in a hospital fridge. The study found that CSP stored in transport containers maintain the same quality and blood clotting ability as those stored in hospital fridges. This conclusion was reached after conducting various laboratory tests. These results help pave the way for planning a clinical trial to test CSP in the treatment of bleeding trauma patients before they reach hospital.

Interviews and a survey revealed all the experts agreed that CSP were worthy of further investigation and that they offered faster/improved clot formation compared to room temperature platelets. The experts agreed that CSP may be suitable for use in a pre-hospital and in-hospital setting, and that their use would generally be acceptable in certain patient groups such as trauma patients with uncontrolled bleeding. 

Main Messages 

• Currently, Golden Hour transport boxes are used by the Welsh air ambulance service to carry two red cell units for up to 72 hours. This study suggests that CSP can be stored in a Golden Hour box for up to 84 hours alongside two red cell units. This helps to support planning for clinical trials on the use of CSP for bleeding patients before they reach hospital.
• Experts agreed that CSP offer potential advantages over standard platelets and may be suitable for use in a pre-hospital and in-hospital setting in certain patient groups.