Hennepin Healthcare is spearheading an effort to enroll trauma patients, including car crash victims, in a clinical trial investigating the early administration of calcium and vasopressin to reduce blood loss. The study, named CAVALIER (CAlcium and VAsopressin following Injury Early Resuscitation), aims to determine if earlier intervention, initiated during transport or upon hospital admission, leads to improved survival rates and reduced blood loss compared to standard treatment protocols.
The rationale behind the CAVALIER trial lies in addressing the "vicious cycle" of bleeding that can escalate by the time patients reach intensive care units, according to Dr. Michael Puskarich, director of research in Hennepin Healthcare’s emergency medicine department. "We get behind the eight ball and sometimes, when we start giving these treatments, it might be too late," Puskarich stated.
Hennepin Healthcare is set to become a key site within the Pittsburgh-based LITES Network, a national study planning to enroll over 1,000 adult trauma victims. Given the potential for patients to be unconscious or severely injured, researchers are seeking a federal exception to enroll individuals without prior informed consent. Once patients are stabilized or their family members are available, researchers will explain the study and seek their continued participation.
Participants in the CAVALIER trial will be administered either intravenous calcium and vasopressin or a placebo. Researchers will then assess the impact on immediate survival odds and survival rates 30 days post-injury. The hospital has issued a public notice regarding the study to ensure community awareness and gather feedback before seeking final approval from local and federal safety oversight boards.
The selection of calcium and vasopressin is based on their established safety profiles, suggesting that earlier use is unlikely to cause significant complications or side effects. However, a critical question remains whether earlier administration will genuinely improve outcomes or potentially disrupt the efficiency of trauma teams in emergency situations.
The Twin Cities area has a history of participation in trauma research, with contributions from Hennepin Healthcare, the University of Minnesota Medical Center, and Regions Hospital in St. Paul. Other emergency studies, such as the HOBIT trial for traumatic brain injuries and the FASTEST trial for brain bleeding after stroke, have also utilized waivers for prior consent in specific circumstances.
