Trial begins of rapid use of clotting drug

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Researchers at the SRMRC have begun a trial to test the practicality of the rapid administering of a drug called Cryoprecipitate, to help stop bleeding in patients who have suffered a serious injury.

Cryoprecipitate is a drug known to be effective in treating people who are bleeding, because it helps blood to clot. Researchers and clinicians want to know how practical it is to administer the drug within 90 minutes of admission to hospital.

Cryoprecipitate is produced by freezing and then defrosting the liquid component of blood, which is called plasma. When frozen plasma is thawed, part of it separates into a substance rich in several compounds which help blood to clot, including fibrinogen and Factor VIII.

This separated substance is cryoprecipitate and it can be re-frozen and stored, then defrosted when needed.

The trial is being conducted in conjunction with colleagues at John Radcliffe Hospital in Oxford. The SRMRC element will involve only military patients, who will receive the drug if they are wounded in Afghanistan. The speed with which these patients can be treated in a military environment will be compared with the speed it can be done at John Radcliffe Hospital.

The trial is an example of the collaboration between military and civilian researchers and clinicians within the SRMRC. The patients wounded in Afghanistan will receive the Cryoprecipitate shortly after admission at the military hospital at Camp Bastion before they are transferred to QEHB for further treament for their wounds. The SRMRC’s research nurses based at QEHB will then take blood samples for testing, as well as monitoring the patient’s condition.

How was Cryoprecipitate discovered?

Cryoprecipitate was discovered in 1964 at Stanford University in the United States. Scientists knew plasma appeared to lose much of its clotting properties after being frozen and defrosted, but did not know why.

It was Judith Graham Pool who first realised this was because the plasma’s clotting factors had in fact formed a new, separated substance in the same container as the defrosted plasma. When she tested this substance, she found it to be rich in clotting factors.

This explained  the poor clotting characteristics of frozen plasma and enabled the development of  a drug which has proved an effective treatment for a wide range of conditions involving uncontrolled bleeding, including major trauma and haemophilia.

The process by which Cryoprecipitate is formed is is called precipitation, and it is similar to the way in which paint separates in a tin if left undisturbed for long enough.

The name “Cryoprecipitate” is formed by joining the Greek word “cryo”, meaning “icy cold” and “precipitate”.

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