{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:12:34Z","timestamp":1770743554967,"version":"3.49.0"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T00:00:00Z","timestamp":1511827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001922","name":"Efficacy and Mechanism Evaluation Programme","doi-asserted-by":"publisher","award":["14\/152\/14"],"award-info":[{"award-number":["14\/152\/14"]}],"id":[{"id":"10.13039\/501100001922","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the \u2018Resuscitation with Pre\u2010HospItaL bLood products\u2019 trial (RePHILL)\u00a0\u2013\u00a0a multi\u2010centre randomised controlled trial of pre\u2010hospital blood product (PHBP) administration vs standard care for traumatic haemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>PHBP are increasingly used for pre\u2010hospital trauma resuscitation despite a lack of robust evidence demonstrating superiority over crystalloids. Provision of PHBP carries additional logistical and regulatory implications, and requires a sustainable supply of universal blood components.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>RePHILL is a multi\u2010centre, two\u2010arm, parallel group, open\u2010label, phase III randomised controlled trial currently underway in the UK. Patients attended by a pre\u2010hospital emergency medical team, with traumatic injury and hypotension (systolic blood pressure\u2009&lt;90\u2009mmHg or absent radial pulse) believed to be due to traumatic haemorrhage are eligible. Exclusion criteria include age\u2009&lt;16\u2009years, blood product receipt on scene prior to randomisation, Advanced Medical Directive forbidding blood product administration, pregnancy, isolated head injury and prisoners. A total of 490 patients will be recruited in a 1\u2009:\u00a01 ratio to receive either the intervention (up to two units of red blood cells and two units of lyophilised plasma) or the control (up to four boluses of 250\u2009mL 0.9% saline). The primary outcome measure is a composite of failure to achieve lactate clearance of \u226520%\/h over the first 2\u2009hours after randomisation and all\u2010cause mortality between recruitment and discharge from the primary receiving facility to non\u2010acute care. Secondary outcomes include pre\u2010hospital time, coagulation indices, in\u2010hospital transfusion requirements and morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pilot study recruitment began in December 2016. Approval to proceed to the main trial was received in June 2017. Recruitment is expected to continue until 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RePHILL will provide high\u2010quality evidence regarding the efficacy and safety of PHBP resuscitation for trauma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.12486","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T15:23:43Z","timestamp":1511969023000},"page":"346-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["RePHILL: protocol for a randomised controlled trial of pre\u2010hospital blood product resuscitation for trauma"],"prefix":"10.1111","volume":"28","author":[{"given":"I. M.","family":"Smith","sequence":"first","affiliation":[{"name":"NIHR Surgical Reconstruction and Microbiology Research Centre University of Birmingham  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Crombie","sequence":"additional","affiliation":[{"name":"NIHR Surgical Reconstruction and Microbiology Research Centre University of Birmingham  Birmingham UK"},{"name":"Department of Anaesthesia University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"},{"name":"West Midlands Ambulance Service Medical Emergency Response Incident Team  Brierley Hill UK"},{"name":"Midlands Air Ambulance  Stourbridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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M.","family":"Hancox","sequence":"additional","affiliation":[{"name":"NIHR Surgical Reconstruction and Microbiology Research Centre University of Birmingham  Birmingham UK"},{"name":"Midlands Air Ambulance  Stourbridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Slinn","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Ives","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Grant","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. D.","family":"Perkins","sequence":"additional","affiliation":[{"name":"West Midlands Ambulance Service Medical Emergency Response Incident Team  Brierley Hill UK"},{"name":"Warwick Clinical Trials Unit University of Warwick  Coventry UK"},{"name":"Critical Care Unit Heart of England NHS Foundation Trust  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Doughty","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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