Fibrinogen Early In Severe Trauma in children studY (FEISTY Junior)

Grant ID: EMPJ-371R27-2017

Project Summary

Traumatic injuries in children are a leading cause of death and disability in Australia. In high income countries, 40% of child deaths are because of traumatic injuries. Fibrinogen is one of the key clotting factors that need to be replaced in severe traumatic bleeding.

Currently, fibrinogen is replaced using cryoprecipitate; a blood product obtained from healthy volunteer donors. This is a precious resource that is stored frozen in the blood bank; it can take a long time to administer and place significant strain on blood banks. Fibrinogen concentrate (FC) is an alternative product used to assist in blood clotting. It is a product that is derived from blood plasma but stored in powder form and can be reconstituted at the bedside and given quickly. The study will investigate whether it is quicker to administer FC than cryoprecipitate, which may reduce haemorrhage and improve outcomes.

This study will enrol 30 children from three major paediatric trauma centres in Queensland admitted with severe traumatic bleeding. Time to administration of fibrinogen replacement and the effect of fibrinogen levels will be measured.

Dissemination

Publication:

- George, S., Wake, E., Jansen, M., Roy, J., Maconachie, S., Paasilahti, A., Wiseman, G., Gibbons, K., Winearls, J., and FEISTY Investigators, 2022. Fibrinogen Early In Severe paediatric Trauma studY (FEISTY junior): protocol for a randomised controlled trial. BMJ open, 12(5), e057780. https://doi.org/10.1136/bmjopen-2021-057780

- George, S., Wake, E., Sweeny, A., Campbell, D. and Winearls, J., 2022. Rotational thromboelastometry in children presenting to an Australian major trauma centre: A retrospective cohort study. Emergency Medicine Australasia, 34(4), pp.590-598. doi: 10.1111/1742-6723.13939

Presentations:

- FEISTY Junior - regional centres (Oral Presentation). 2022 Emergency Care Research Symposium, Gold Coast University Hospital, September 2022.

- Campbell, D., Wake, E., FEISTY Junior (oral presentation). Australian Trauma Society October 2018.

- George, S., Getting a Little FEISTY - Fibrinogen Replacement in Paediatric Trauma (oral presentation). ACEM ASM 2018. Perth, Australia.

- George, S., FEISTY Junior (oral and poster presentation). GCHHS Research Week 2018. Gold Coast, Australia.

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