Evaluation of a Transfusion Therapy Using Whole Blood in the Management of Coagulopathy in Patients With Acute Traumatic Hemorrhage (T-STORHM)

  • End date
    Sep 23, 2024
  • participants needed
  • sponsor
    Direction Centrale du Service de Santé des Armées
Updated on 23 April 2022
blood transfusion
packed red blood cells
pelvic fracture
Accepts healthy volunteers


The prognosis of traumatized hemorrhages is correlated with the nature of transfusion therapy: a 50% reduction in mortality for an early and massive supply of plasma, and 20% for an early and massive supply of platelets. However, this strategy encounters logistical difficulties, particularly in a context of collective emergency (attacks). The use of whole blood, widely documented by the Armed Forces, improves the availability of plasma and platelets, and simplifies handling by the various actors in the chain.

T-STORHM is a randomized, controlled, parallel clinical trial.This study tests non-inferiority of whole blood transfusion therapy in the management of coagulopathy in patients with acute traumatic hemorrhage.


In recent years, terrorist attacks have confronted the investigator's healthcare system with a massive influx of victims of war weapon injuries. This new fact makes the efficiency of transfusion therapy crucial: hemorrhage is the leading cause of death from weapons of war, and the high number of victims of each attack changes the logistical approach.

The logistical problems with transfusion therapy, including red blood cell (PRBCs), plasma and platelet concentrates, are the speed of delivery and availability. Using whole blood is a pragmatic solution to overcome these problems. This solution has been used for many years by the French Army to ensure platelet transfusion in traumatic hemorrhages

The hypothesis of the T-STORHM study is that the use of whole blood is a solution in a context of civil trauma not effective less than component therapy (PRBCs, plasma and platelet concentrates) in the management of coagulopathy in patients admitted to hospital for traumatic hemorrhage.

Condition Trauma, Acute Hemorrhage, Coagulopathy
Treatment Whole Blood transfusion, Fractionated blood products transfusion
Clinical Study IdentifierNCT04431999
SponsorDirection Centrale du Service de Santé des Armées
Last Modified on23 April 2022


Yes No Not Sure

Inclusion Criteria

Severe trauma patients requiring the initiation of a massive transfusion protocol
determined on
At least two Red flag score factors (according to pre-hospital data)
Suspected pelvic fracture
Shock index (FC / PAS)> = 1
Microdose hemoglobin <13g
Average blood pressure <70 mmHg
Need for prehospital tracheal intubation
AND at least two criteria of the Assessment of Blood Consumption (ABC) score
established at the patient's arrival
Penetrating trauma
Focused Abdominal Sonography for Trauma (FAST) echo positive
Blood pressure <90 mmHg
Respiratory rate >120 bpm
AND/OR on the prediction of the practitioner (clinical diagnosis) in charge of the
treatment of the injured person of the need to transfuse at least 4 PRBCs within 6
hours after the admission of the trauma patient

Exclusion Criteria

Non-traumatic hemorrhage
Patients transfused with more than two PRBCs before the initiation of the massive
transfusion protocol
Anti-coagulation treatment
Age < 18 years
Patient refusing administration of blood products
Patient transferred from another hospital
Patient nor transported by a physician-staffed prehospital emergency medical system
Burn patient (≥30% of body surface)
No affiliated to the social security
Person deprived of liberty by a legal or administrative decision, person under
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