Reasearch project on Blood Substitutes

[spekaldpez]

Anybody have any info or experience with blood transfusion substitutes such as polyheme.. I know its in trial phases but none around here... Or any other product used for trauma fluid replacement besides NS LR or D5

thanks.

[Richard B the EMT]

We had a lot of discussion of the Polyheme on the old board. Until and unless some of the folks previously posted there answer you here, all I can recommend is to work your favorite search engine.

[Ridryder 911]

Check out Defrance web site. Site usually has the current research on Polyheme. Like to know how it is going, & if favorable to buy stock yet....

Be safe,

Ridryder 911

[Tdillon193]

Denver Health (911 provider for Denver CO) ran a Polyheme trial a while back. Don't know for sure, but the rumor is that the results were so significantly positive with the blood substitute (vs. just using NS) that they stopped the trial so they could use the Polyheme with all their patients. At any rate, they now carry it on their ambulances from what I hear. They'd be a good agency to check with about Polyheme, www.denverems.org

[ptemt]

Here is the link to Northfield Labs;

http://www.northfieldlabs.com/

[Guest]

I don't know if they are allowed to run the substitute exclusively yet it is still being tested. KU med center has Four county services around the KC metro area in Kansas testing it now.

[MedicRN]

Role in research rejected: A national study that could revolutionize the treatment of trauma victims will move forward. But without Johnson County.

The full article will be available on the Web for a limited time:

http://www.kansascity.com/mld/kansascity/n...al/13016786.htm

[Dustdevil]

The full article will be available on the Web for a limited time:

Very limited. :?

Now it takes you to a registration page to view the article.

Can you summarize for us?

[MedicRN]

Sorry.... here's the article

Posted on Fri, Oct. 28, 2005

Ambulance crews would have used artificial blood in Johnson County

Role in research rejected

By FINN BULLERS and ALAN BAVLEY

The Kansas City Star

A national study that could revolutionize the treatment of trauma victims will move forward.

But without Johnson County.

Annabeth Surbaugh, the county’s top elected official, cast a tying vote that barred the county’s Med-Act ambulance service from participating in an ongoing study conducted by University of Kansas Medical Center to test whether artificial blood used at the scenes of accidents could help save more lives.

The County Commission’s support would have given emergency crews implied consent to treat trauma patients with artificial blood without their approval.

Surbaugh said she came to Thursday’s meeting prepared to support the study but changed her mind when she learned the details of how it would be administered.

“I didn’t know enough to vote yes, so I voted no,†Surbaugh said after the vote. “Perhaps this is because of my lack of medical understanding.â€

The study — approved in Wyandotte, Douglas and Leavenworth counties — will continue despite the no vote in Johnson County.

A commissioner who voted for inclusion in the study said the vote sent a troubling message as Kansas leaders bank on an emerging life sciences initiative to spark a new growth industry in the Sunflower State.

Earlier this month, Surbaugh and her colleagues sang the praises of a new life sciences research park that Gov. Kathleen Sebelius envisioned at the former Sunflower Army Ammunition Plant near De Soto.

“But it troubles me in looking ahead,†Commissioner Dolores Furtado said after the vote. “How can we celebrate the potential of a research park at Sunflower dedicated to bioresearch†while sending an anti-science message?

“It has to have a detrimental impact on any bioresearch firm that may consider locating in Kansas,†said Furtado, professor emeritus of microbiology at the University of Kansas Medical Center.

Also citing the county’s biotech future, Commissioner John Toplikar voted against the study. Participating would lead the county down the wrong road as a Kansas 10 “biotechnology corridor†begins to emerge between the Stowers Institute in Kansas City and the University of Kansas in Lawrence, Toplikar said.

“If we approve this study, what study is next?†he asked.

He said the study “takes away the basic human rights†of people by enrolling them in a study they can’t decline without wearing opt-out wristbands.

The study is expected to begin on schedule in mid-November, even without Johnson County’s participation, KU Medical Center spokesman Dennis McCulloch said.

“We’re disappointed, but the project will go on, and we’ll still be part of this national research,†McCulloch said.

McCulloch said the medical center was surprised by the continuing doubts about the study raised by the County Commission.

“We were kind of stunned by the questions,†he said. “We think we had answered their questions.â€

Since early last year, an experimental blood substitute known as PolyHeme has been given to hundreds of U.S. trauma patients suffering life-threatening blood losses at accident scenes.

PolyHeme has been tested extensively in hospital emergency rooms. More than 20 medical centers nationwide are participating in the ambulance study. But other hospitals have declined to participate.

Researchers face sticky ethical questions on whether trauma patients unable to make informed decisions about their treatments should be transfused with PolyHeme without their consent. Under normal circumstances, that’s forbidden.

But it does happen.

“There are areas of research in which new medications do get used without traditional informed consent,†said Gary Pettett, a program associate of the Center for Practical Bioethics and director of the office of research integrity at Children’s Mercy Hospital.

These situations include research involving young children where the approval of their parents is sought and emergency care where patients are incapacitated.

“If we’re ever going to improve the kind of care available in emergency settings, we’re going to have to be able to study it like this,†Pettett said.

Studies without informed consent can be ethically justified, he said, if an experimental treatment is likely to benefit patients and if its risks have been minimized.

“It sounds to me the (PolyHeme) study has passed muster as far as it can in the emergency setting,†he said.

“But you have to be willing to accept community assent as an ethical substitute for informed consent. If that is still an ethical dilemma for (the County Commission), I don’t think there’s any way around it for them. I think you have to honor that decision.â€

T.J. Clark of Olathe told commissioners Thursday he did not want them to make medical choices for him.

“This is an experiment,†said Clark, a local radio talk show host. “We need to scream it from the rooftop.â€

The message to the public is that “your County Commission has decided you’re going to be a guinea pig,†he said.

Furtado chalked up the vote to pre-election posturing.

“Annabeth took me by surprise,†Furtado said. “I think it (her vote) is political. She is serving the conservative base — be it so they don’t mobilize a candidate to run against her or be it to win the race, I don’t know.â€

Surbaugh, who has announced a bid for another four-year term as county chairwoman next fall, denied the allegation.

“My decision was not a political decision,†she said.

Had she been given more time to study the issue she said she may have drawn a different conclusion. The commission had already delayed its vote one week.

Commissioner Dave Lindstrom also voted against participating in the study, saying he was concerned that participants would continue to receive PolyHeme even after real blood was available at the hospital.

Commissioner Doug Wood abstained from voting, saying, “I do not want to substitute my judgment for those of my constituents.â€

Commissioners Furtado, Ed Peterson and John Segale supported the study.

The vote reflects the conservative/moderate split that surfaced during this year’s budget deliberations.

Segale said Thursday’s debate got sidetracked by questions of morality and ethics.

When emergency responders make life-or-death decisions to pump saline into trauma victims to stabilize blood pressure, they don’t ask for permission, he said. This study is to decide whether to take a calculated risk to save lives — and it is worth taking, Segale said.

Ted McFarlane, director of the ambulance service, said a review of 75 Johnson County trauma cases transported to KU Medical Center in the last year showed no case that would have qualified for inclusion in the study.

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What is PolyHeme?

■ It is produced from human blood and retains blood’s ability to carry oxygen to body tissues. PolyHeme is more practical than blood for use on ambulances because it’s easier to store and has a longer shelf life than blood. And it can be given to people without matching blood types.

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The study

â– â– More than 400 patients have been enrolled in the ambulance study. KU Medical Center expects to contribute about 40 patients to the study. It will continue until 720 patients are enrolled.

â–  Half of these trauma patients will receive PolyHeme, the rest conventional therapy with intravenous fluids.

â–  Johnson County was expected to supply about four of those patients by ground transport and two to three times that number by air ambulance. Without Johnson County, it will take scientists longer to get their research numbers.

[Guest]

That is a sad set back. To walk around saying yes yes yes bring the research to us and let us be a part of the future, Only to turn around and say, Ummm No I no longer wish to do this because i don't understand it. Typical political BS!!!!!! The people do have a choise, That is what the opt out bracelets are for. Seems like they do not want to do their job and keep the public that they serve informed enough to make a decition for themselves. It's no wonder why few major industries look to Kansas for possible expantion and relocation.

Sorry im off the soap box now ....lol