A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2)

BMC Emergency Medicine

Study Protocol

Markus W Hollmann¹  Marcel GW Dijkgraaf²  Johannes B Reitsma²  Joachim Hohmann³  Ludo FM Beenen⁴  Jan SK Luitse⁵  Teun Peter Saltzherr⁵  Joanne C Sierink⁵  J Carel Goslings⁵  James W Suliburk⁶  Peter Patka⁷  Benn JA Beuker⁸  Michael JR Edwards⁹ 

[1] Department of Anaesthesiology Academic Medical Center, Amsterdam, The Netherlands;Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands;Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland;Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands;Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands;Trauma Unit Department of Surgery, Ben Taub General Hospital, Houston, USA;Trauma Unit Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands;Trauma Unit Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands;Trauma Unit Department of Surgery, University Medical Center Sint Radboud, Nijmegen, The Netherlands;

关键词: Compute Tomography Scanning;    Trauma Patient;    Trauma Care;    Ambulance Personnel;    Trauma Room;   

DOI  :  10.1186/1471-227X-12-4

 received in 2012-02-16, accepted in 2012-03-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundComputed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total-body CT scanning in trauma patients.Methods/designThe REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. Patients in whom direct scanning will hamper necessary cardiopulmonary resuscitation or who require an immediate operation because of imminent death (both as judged by the trauma team leader) are excluded. Randomization will be computer assisted. The intervention group will receive a contrast-enhanced total-body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness.DiscussionThe REACT-2 trial is a multicenter randomized clinical trial that will provide evidence on the value of immediate total-body CT scanning during the primary survey of severely injured trauma patients. If immediate total-body CT scanning is found to be the best imaging strategy in severely injured trauma patients it could replace conventional imaging supplemented with CT in this specific group.Trial RegistrationClinicalTrials.gov: (NCT01523626).

【 授权许可】

CC BY   
© Sierink et al; licensee BioMed Central Ltd. 2012