01 September 2011

Recruitment landmark in major blood conservation in cardiac surgery study

Researchers at University Hospitals Bristol NHS Foundation Trust have now recruited more than 50 per cent of the 2,400 participants in the world's largest study to investigate better ways to detect blood clotting problems in patients undergoing heart surgery.

The study: Coagulation and Platelet Function Testing in Cardiac Surgery (COPTIC) aims to identify cardiac surgery patients who are at increased risk of bleeding during and after the operation and to improve how blood products are used to treat excessive bleeding. The results of the study will affect the way in which cardiac surgery patients are treated worldwide.

The study, which was funded by a National Institute for Health Research Programme Grant award for £1.4 million, is led by Mr Gavin Murphy, Reader in Cardiac Surgery and Dr Andrew Mumford, Reader in Haematology at University Hospitals Bristol.

Mr Gavin Murphy says: "Patients who are about to undergo bypass cardiac surgery are given drug treatments to thin their blood. However, after the surgery has been completed we need the blood to clot to prevent excessive bleeding in the patient. Patients are given drug treatments and blood transfusions to assist with this, but 15 per cent of those will suffer severe bleeding following the surgery.

"Many patients suffering from severe bleeding will need a massive blood transfusion, sometimes up to 20 units. Such large transfusions can have detrimental effects on the patient's lungs and kidneys."

Dr Andrew Mumford says: "This study recognises that bleeding and blood transfusions in heart surgery are often the consequence of abnormal blood clotting, which can have multiple causes in this patient population.

"By taking a small blood sample just before and at the end of the operation and performing a variety of different laboratory tests, we will be able to find the most informative tests to identify and treat clotting disorders and, in turn, avoid bleeding and blood transfusions."

Mr Gavin Murphy says: "This is the largest study of its kind in the world and the team are on course to complete the study in December 2012. Since April 2010 we have recruited over 1,300 patients at University Hospitals Bristol, which represents 80% of all patients undergoing cardiac surgery at our centre since the trial began.

"It has only been possible because of the way in which it has been funded by the NIHR and also through the coordinated work of a large and diverse group of staff across the hospital Trust."

Staff members collaborating on the study include the cardiac anaesthetists, surgical teams, the cardiac theatre operating department assistants, porters, intensive care nurses, the Clinical Trials and Evaluation Unit, research nurses and biomedical scientists in the coagulation laboratory.

Chief Medical Officer Professor Dame Sally C Davies said: "I am pleased to see that this recruitment landmark has been reached. This is important research that should provide evidence of great value to the NHS, and beyond. Identifying those at risk of bleeding during surgery with a view to avoiding transfusion will be of great benefit to patients, allowing many to avoid the complications and distress that can be associated with this procedure."

The study, which was funded by a National Institute for Health Research Programme Grant award for £1.4 million, is led by Mr Gavin Murphy, Reader in Cardiac Surgery and Dr Andrew Mumford, Reader in Haematology at University Hospitals Bristol.

Researchers at University Hospitals Bristol NHS Foundation Trust have now recruited more than 50 per cent of the 2,400 participants in the world's largest study to investigate better ways to detect blood clotting problems in patients undergoing heart surgery.

The study: Coagulation and Platelet Function Testing in Cardiac Surgery (COPTIC) aims to identify cardiac surgery patients who are at increased risk of bleeding during and after the operation and to improve how blood products are used to treat excessive bleeding. The results of the study will affect the way in which cardiac surgery patients are treated worldwide.

The study, which was funded by a National Institute for Health Research Programme Grant award for £1.4 million, is led by Mr Gavin Murphy, Reader in Cardiac Surgery and Dr Andrew Mumford, Reader in Haematology at University Hospitals Bristol.

Mr Gavin Murphy says: "Patients who are about to undergo bypass cardiac surgery are given drug treatments to thin their blood. However, after the surgery has been completed we need the blood to clot to prevent excessive bleeding in the patient. Patients are given drug treatments and blood transfusions to assist with this, but 15 per cent of those will suffer severe bleeding following the surgery.

"Many patients suffering from severe bleeding will need a massive blood transfusion, sometimes up to 20 units. Such large transfusions can have detrimental effects on the patient's lungs and kidneys."

Dr Andrew Mumford says: "This study recognises that bleeding and blood transfusions in heart surgery are often the consequence of abnormal blood clotting, which can have multiple causes in this patient population.

"By taking a small blood sample just before and at the end of the operation and performing a variety of different laboratory tests, we will be able to find the most informative tests to identify and treat clotting disorders and, in turn, avoid bleeding and blood transfusions."

Mr Gavin Murphy says: "This is the largest study of its kind in the world and the team are on course to complete the study in December 2012. Since April 2010 we have recruited over 1,300 patients at University Hospitals Bristol, which represents 80% of all patients undergoing cardiac surgery at our centre since the trial began.

"It has only been possible because of the way in which it has been funded by the NIHR and also through the coordinated work of a large and diverse group of staff across the hospital Trust."

Staff members collaborating on the study include the cardiac anaesthetists, surgical teams, the cardiac theatre operating department assistants, porters, intensive care nurses, the Clinical Trials and Evaluation Unit, research nurses and biomedical scientists in the coagulation laboratory.

Chief Medical Officer Professor Dame Sally C Davies said: "I am pleased to see that this recruitment landmark has been reached. This is important research that should provide evidence of great value to the NHS, and beyond. Identifying those at risk of bleeding during surgery with a view to avoiding transfusion will be of great benefit to patients, allowing many to avoid the complications and distress that can be associated with this procedure."

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