Episode 55: AAST 2022 Hot Topics - From Sex Dimorphisms in Coagulation to TXA, TEG, Calcium and Beyond with Drs. Bryan A. Cotton, Neil Parry, Nori Bradley, Jordan Weinberg, Joshua Brown & Alyssa MacLe

Join us after hours at Dr. Bryan A. Cotton's pop-up bourbon bar at the AAST 2022 Meeting in Chicago. In this FANTASTIC & FUN episode, we talk amongst friends about cutting edge research at this year's meeting. To no one's surprise, coagulopathy, damage control resuscitation, whole blood, and factor replacement therapy just happen to be but a few of the topics discussed on Rounds.

Time Stamps:

00:12 AAST 2022 - Intro

00:42 Sex diamoprhisms in coagulation

01:52 Hemostatic profiles of female donors

02:48 Pediatric whole blood (WB) is safe

03:10 WB for TBI

03:31 Leukoreduction is unnecessary

05:30 TXA, TEG  and trauma

06:44 STAAMP trial

07:21 TXA: go early, big or go home

07:52 Calcium...early!

09:33 Canadian perspective on TXA and TEG – Neil Perry from London, ON

11:25 Nori Bradley from Edmonton, AB

13:53 Jordan Weinberg, not Canadian – Phoenix, AZ

16:12 Issues with WB – COMBAT vs PAMPer

17:31 Cold stored platelets

18:22 Rapid transfusers and whole blood: Only the strong survive!!

19:42 How are we doing with our resuscitation? 1:1:1 is just the beginning, not the end!

21:44 Timing is everything!

23:38 Plasma first resuscitation: “…God damn good!” -BAC

24:37 Dr. Joshua B. Brown - Pittsburgh, PA

25:31 More Canadian perspectives with Perry and Bradley

29:48 Less is best!

31:27 Prothrombin complex concentrate: Yay or nay?

32:18 More on the endotheliopathy of trauma

33:38 Just messing around and having a blast

34:22 What was the best bourbon tonight?

References:

CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejía-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PMID: 20554319.

Gruen DS, Guyette FX, Brown JB, Okonkwo DO, Puccio AM, Campwala IK, Tessmer MT, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Neal MD, Zuckerbraun BS, Yazer MH, Billiar TR, Sperry JL. Association of Prehospital Plasma With Survival in Patients With Traumatic Brain Injury: A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2016869. doi: 10.1001/jamanetworkopen.2020.16869. PMID: 33057642; PMCID: PMC7563075.

Guyette FX, Brown JB, Zenati MS, Early-Young BJ, Adams PW, Eastridge BJ, Nirula R, Vercruysse GA, O'Keeffe T, Joseph B, Alarcon LH, Callaway CW, Zuckerbraun BS, Neal MD, Forsythe RM, Rosengart MR, Billiar TR, Yealy DM, Peitzman AB, Sperry JL; STAAMP Study Group. Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical Trial. JAMA Surg. 2020 Oct 5;156(1):11–20. doi: 10.1001/jamasurg.2020.4350. Epub ahead of print. Erratum in: JAMA Surg. 2021 Jan 1;156(1):105. PMID: 33016996; PMCID: PMC7536625.

Moore HB, Moore EE, Chapman MP, McVaney K, Bryskiewicz G, Blechar R, Chin T, Burlew CC, Pieracci F, West FB, Fleming CD, Ghasabyan A, Chandler J, Silliman CC, Banerjee A, Sauaia A. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018 Jul 28;392(10144):283-291. doi: 10.1016/S0140-6736(18)31553-8. Epub 2018 Jul 20. PMID: 30032977; PMCID: PMC6284829.

Pusateri AE, Moore EE, Moore HB, Le TD, Guyette FX, Chapman MP, Sauaia A, Ghasabyan A, Chandler J, McVaney K, Brown JB, Daley BJ, MSupport the show