Treatment for Common TBI Complication Shown To Be Ineffective

Nearly 2 million Americans experience a traumatic brain injury every year, and approximately half experience bleeding inside or around the brain. The bleeding greatly increases the risk of disability or death, and a recent study suggests a common treatment for this complication is less effective than previously believed.

Bleeding inside or around the skull, or “traumatic intracranial hemorrhage” is frequently treated with a transfusion of platelets, which are intended to help blood clot, and the administration of desmopressin, a naturally occurring hormone used to treat bleeding.

According to a study from Los Angeles Biomedical Research Institute, published online in the Journal of Neurotrauma, this treatment does little to prevent further bleeding in the brain or reducing the risk of death following traumatic brain injury.

“Previous studies of platelet transfusion have looked only at mortality, and few studies have addressed the effect of DDAVP on bleeding in patients with TBI,” said Dennis Yong Kim, MD, an LA BioMed lead researcher and author of the study.

“Our study found that the administration of platelets and DDAVP is no more effective in preventing progression of hemorrhage or death than was the use of none of these medications, irrespective of whether or not patients were on antiplatelet medications, such as aspirin, prior to their TBI. Given the limited availability and potential for complications associated with transfusion of blood products like platelets, we believe that physicians should take a step back and re-think the necessity and efficacy of such treatments in patients with TBI.”

The team of researchers conducted a three-year retrospective examination of patient records of individuals admitted to a Level 1 trauma center for TBI from 2010 through 2012. Of the 408 who fit the criteria, 126 received platelet transfusions and desmopressin, and 282 individuals did not.

Out of all eligible patients, 37% showed traumatic intracranial hemorrhage within four hours of admission. After comparing the outcomes for those administered platelet transfusions and desmopressin and those who did not receive the treatment, the researchers saw there was no difference in mortality or hemorrhage progression between either groups.

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