Research
Trauma is a leading cause of morbidity and mortality worldwide, with over 17,000 deaths per year in the UK.
The research department within Barts and The London Trauma Centre, led by Professor Karim Brohi at The Royal London Hospital, is an internationally renowned unit conducting cutting-edge research to improve care for severely injured patients.
Known within the centre as the Trauma Clinical Academic Unit, our team of researchers and scientists work on both basic science and clinical research programmes with many other clinical and research teams across the hospital. Also with those in the Institute of Cell and Molecular Science and the William Harvey Research Institute, part of Barts and The London School of Medicine and Dentistry.
The Trauma Centre at The Royal London Hospital is collaborating on many national and international projects with its research partners which include:
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Trauma centres in Oslo, Amsterdam, Copenhagen and Cologne
Blood transfusions and clotting
In August 2008, a collaboration of Barts and The London Trauma Centre, the National Blood Service and University Oxford was awarded a £2 million programme grant from the National Institute of Health Research (NIHR).
The grant was awarded to investigate major bleeding caused by trauma to improve treatment and ultimately save lives. Severe haemorrhage as a result of major injury is a threat to life.
Bleeding results from damaged blood vessels, but it is also due to the difficulties in blood clotting.
Blood transfusions are an important part of the treatment, but they carry their own risks and side effects.
Red blood cell transfusions lack important clotting factors. Currently, after patients have received a certain number of red cell transfusions, plasma and platelet transfusions are given to replace these lost clotting factors.
Research at the trauma centre has identified that some patients do not clot properly even before they have had any transfusions, as clotting is disrupted by the blood loss itself.
This has led several research groups to review their data. As a result it was found that early, aggressive treatment appeared to improve survival.
There are currently no routine tests of blood clotting that provide answers within a useable timeframe. Thus, some patients receive too few clotting factors and have worse outcomes, while some may receive too many and be exposed to extra risks. This is also a waste of precious blood stocks.
These changes in our understanding mean there are some fundamental questions that need to be answered and they could have a major impact on outcomes.
The five year NIHR programme will study these issues in the context of the population of England and Wales and the impact of changes in practice to patients, the National Blood Service and the NHS.
The outputs of the programme will have a major impact on the survival of trauma patients, the effectiveness of hospital and national transfusion services and to the NHS and society in general.
