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CompletedNCT04726410CriSP-TBIUpdated May 11, 2025Results posted

Cold-stored Platelet Early Intervention in TBI

A Phase 2 interventional study of Cold Stored Platelets and Standard Care in Traumatic Brain Injury, sponsored by Jason Sperry. Completed at 1 site in United States. Open to participants aged 18 Years to 89 Years. Per ClinicalTrials.gov, last updated 2025-05-11.

Sponsored by Jason Sperry · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years to 89 Years
Sex
All
01

Study summary

The Cold Stored Platelet Early Intervention in Traumatic Brain Injury (CriSP-TBI) trial is a proposed 3 year, open label, single center, randomized trial designed to determine the feasibility, efficacy, and safety of urgent release cold stored platelets (CSP) in patients with TBI requiring platelet transfusion. Patients will be randomized to receive either standard care or early infusion of urgent release cold stored platelets (CSP). The proposed pilot study will enroll at the University of Pittsburgh and will enroll approximately 100 patients. The primary outcome for the pilot trial is feasibility, with principal secondary clinical outcome of 6-month Extended Glasgow Outcome Scale (GOS-E).

Read the detailed description

Platelet transfusion is commonly provided to patients with moderate or severe TBI who are on antiplatelet medications. Evidence suggests that patients on antiplatelet medications may have worse outcomes following TBI. Current literature has not demonstrated major outcome improvements in those patients who receive platelet transfusion. This lack of significant benefit may be due to insufficient dosing or due to the poor hemostatic function of standard care room temperature platelets. Studying the potential benefits of Cold Stored Platelet transfusion in the TBI population will provide needed direct comparison of room temperature and cold stored platelet transfusion which is unable to occur in patients with hemorrhagic shock, who may require large volumes of red blood cells and plasma concomitantly with platelet transfusion.

By providing Cold Stored Platelets in an urgent release fashion following injury, a potentially superior hemostatic agent is given early, closer to the time of injury. The current pilot trial was designed to determine the feasibility, efficacy and safety of urgent release cold stored platelets as compared to standard care in TBI patients requiring platelet transfusion. There are no high-level data which appropriately characterize the urgent release use of cold stored platelets out to 14 days or their function over that time period as compared to standard room temperature platelets. These results will be able to inform future large randomized clinical trials allowing the most appropriate injured population, inclusion criteria, and primary outcome to be selected and utilized.

02

Conditions studied

  • Traumatic Brain Injury

Keywords

  • Traumatic Brain Injury
  • Cold Stored Platelets
03

Who can participate

Ages eligible
18 Years to 89 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Patients with traumatic brain injury, defined by presence of potential progressive intracranial injury on CT scan, at significant risk for urgent neurosurgical procedure as determined by neurosurgical evaluation, who meet at least one of the following:

  1. History or indication of pre-injury antiplatelet agent use
  2. Need for platelet transfusion per standard practice

Exclusion criteria

Exclusion Criteria:

  1. Wearing NO CriSP opt out bracelet
  2. Hypotension in Emergency Department (SBP\< 90 mmHg)
  3. Age > 89 or \< 18 years of age
  4. Penetrating injury
  5. Prisoner
  6. Pregnancy
  7. Going to operating room for non-neurosurgical intervention in first 60 minutes
  8. Platelet transfusion contraindications per care team (for example, recent vascular stent, embolic stroke, intracranial and/or vascular lesions)
  9. Objection to study voiced by participant or family member in Emergency Department
  10. Currently on therapeutic anticoagulant in addition to aspirin and/or clopidogrel (e.g. warfarin, direct-acting oral anticoagulants)
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
100 participants (actual)

Study arms

  • Experimental
    Cold-stored Platelet (CSP)

    early infusion of up to 2 units of urgent release cold stored platelets (CSP)

    Biological: Cold Stored Platelets

  • Active comparator
    Standard care

    standard care therapy

    Biological: Standard Care

Interventions

  • BiologicalCold Stored Platelets

    early infusion of urgent release CSP

  • BiologicalStandard Care

    standard care including room temperature platelets

05

What researchers measure

Primary outcomes

  1. Study Feasibility

    proportion of eligible patients that can be randomized, enrolled, adhere to protocol, and complete follow-up

    Time frame: 6 months

Secondary outcomes

  1. 6-month Extended Glasgow Outcome Scale (GOS-E)

    A tool used to characterize 6-month functional status into 8 defined categories, with 1 being the worst (death) to 8 being the most favorable (good recovery).

    Time frame: 6 months after enrollment

  2. 24-hour Mortality

    Mortality within 24 hours

    Time frame: Enrollment through 24 hours

  3. In-hospital Mortality

    Mortality in-hospital

    Time frame: Enrollment through discharge up to 6 months

  4. TBI Progression

    Evidence of progression of TBI. Common Data Elements for CT scan indicators of TBI progression will be utilized.

    Time frame: Enrollment through 24 hours

  5. Galveston Orientation and Amnesia Test (GOAT)

    10-item questionnaire used to quickly assess post-traumatic amnesia following head injury. The GOAT is read orally to the patient and may be easily administered at the bedside. The total score accounts for orientation of person, place, and time, and recollection of events pre and post- injury. Cutoff scores are available to identify abnormal, borderline, and normal orientation. The total GOAT score is obtained by deducting the sum of the error points from each incorrect response from 100.Range is 0-100. A score of 66 or lower is categorized as "impaired," 66-75 as "borderline," and 76-100 as "normal." This will be obtained At Discharge from Current Hospital Admission

    Time frame: At Discharge from Current Hospital Admission

  6. Incidence of Allergic/Transfusion Reaction

    Any transfusion complication in Emergency Department or Operating Room

    Time frame: Enrollment through 24 hours

  7. Incidence of Transfusion Related Acute Lung Injury (TRALI)

    Occurrence of Acute Respiratory Distress Syndrome (ARDS) within 6 hours of transfusion of platelets

    Time frame: Enrollment through 48 hours

  8. Incidence of Thromboembolic Events

    Incidence of pulmonary embolism, venous thrombosis, or arterial thrombosis

    Time frame: Enrollment through 48 hours

06

Results

Posted Apr 29, 2025

Participant flow

Participant flow — Overall Study
MilestoneCold-stored Platelet (CSP)Standard Care
Started5050
Completed5049
Not completed01

Outcome measures

PrimaryStudy Feasibility

proportion of eligible patients that can be randomized, enrolled, adhere to protocol, and complete follow-up

Time frame:
6 months
Reported as:
Count of participants · Participants
Study Feasibility
ParticipantsCold-stored Platelet (CSP)Standard Care
Study Feasibility5050
Secondary6-month Extended Glasgow Outcome Scale (GOS-E)

A tool used to characterize 6-month functional status into 8 defined categories, with 1 being the worst (death) to 8 being the most favorable (good recovery).

Time frame:
6 months after enrollment
Reported as:
Count of participants · Participants
6-month Extended Glasgow Outcome Scale (GOS-E)
ParticipantsCold-stored Platelet (CSP)Standard Care
Unfavorable2120
Favorable2220
Secondary24-hour Mortality

Mortality within 24 hours

Time frame:
Enrollment through 24 hours
Reported as:
Count of participants · Participants
24-hour Mortality
ParticipantsCold-stored Platelet (CSP)Standard Care
24-hour Mortality10
SecondaryIn-hospital Mortality

Mortality in-hospital

Time frame:
Enrollment through discharge up to 6 months
Reported as:
Count of participants · Participants
In-hospital Mortality
ParticipantsCold-stored Platelet (CSP)Standard Care
In-hospital Mortality67
SecondaryTBI Progression

Evidence of progression of TBI. Common Data Elements for CT scan indicators of TBI progression will be utilized.

Time frame:
Enrollment through 24 hours
Reported as:
Count of participants · Participants
TBI Progression
ParticipantsCold-stored Platelet (CSP)Standard Care
TBI Progression811
SecondaryGalveston Orientation and Amnesia Test (GOAT)

10-item questionnaire used to quickly assess post-traumatic amnesia following head injury. The GOAT is read orally to the patient and may be easily administered at the bedside. The total score accounts for orientation of person, place, and time, and recollection of events pre and post- injury. Cutoff scores are available to identify abnormal, borderline, and normal orientation. The total GOAT score is obtained by deducting the sum of the error points from each incorrect response from 100.Range is 0-100. A score of 66 or lower is categorized as "impaired," 66-75 as "borderline," and 76-100 as "normal." This will be obtained At Discharge from Current Hospital Admission

Time frame:
At Discharge from Current Hospital Admission
Reported as:
Median · score on a scale
Galveston Orientation and Amnesia Test (GOAT)
score on a scaleCold-stored Platelet (CSP)Standard Care
Galveston Orientation and Amnesia Test (GOAT)95 (72 to 100)91 (71 to 100)
SecondaryIncidence of Allergic/Transfusion Reaction

Any transfusion complication in Emergency Department or Operating Room

Time frame:
Enrollment through 24 hours
Reported as:
Count of participants · Participants
Incidence of Allergic/Transfusion Reaction
ParticipantsCold-stored Platelet (CSP)Standard Care
Incidence of Allergic/Transfusion Reaction00
SecondaryIncidence of Transfusion Related Acute Lung Injury (TRALI)

Occurrence of Acute Respiratory Distress Syndrome (ARDS) within 6 hours of transfusion of platelets

Time frame:
Enrollment through 48 hours
Reported as:
Count of participants · Participants
Incidence of Transfusion Related Acute Lung Injury (TRALI)
ParticipantsCold-stored Platelet (CSP)Standard Care
Incidence of Transfusion Related Acute Lung Injury (TRALI)00
SecondaryIncidence of Thromboembolic Events

Incidence of pulmonary embolism, venous thrombosis, or arterial thrombosis

Time frame:
Enrollment through 48 hours
Reported as:
Count of participants · Participants
Incidence of Thromboembolic Events
ParticipantsCold-stored Platelet (CSP)Standard Care
Incidence of Thromboembolic Events10

Adverse events

Collected over 6 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cold-stored Platelet (CSP)6/50 (12%)9/50 (18%)0/50 (0%)
Standard Care7/49 (14.3%)8/49 (16.3%)0/49 (0%)
Most frequent serious events
Most frequent serious events
EventCold-stored Platelet (CSP)Standard Care
otherInfections and infestations2/504/49
PneumoniaRespiratory, thoracic and mediastinal disorders3/502/49
Acute kidney injuryRenal and urinary disorders2/501/49
seizuresNervous system disorders0/501/49
pulmonary consolidationRespiratory, thoracic and mediastinal disorders1/500/49
deep vein thrombosisVascular disorders1/500/49

Baseline characteristics

Age, Continuous
Age, Continuous(years)Cold-stored Platelet (CSP)Standard CareTotal
Median73.5 (67 to 80)78 (66 to 82)76 (66 to 81)
Sex: Female, Male
Sex: Female, Male(Participants)Cold-stored Platelet (CSP)Standard CareTotal
Female232447
Male272653
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Cold-stored Platelet (CSP)Standard CareTotal
American Indian or Alaska Native000
Asian011
Native Hawaiian or Other Pacific Islander000
Black or African American459
White443781
More than one race000
Unknown or Not Reported279
Region of Enrollment
Region of Enrollment(Participants)Cold-stored Platelet (CSP)Standard CareTotal
United States5050100
07

Study locations

1 site
  • University of Pittsburgh
    Pittsburgh, Pennsylvania 15213, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Feb 8, 2023
  • Informed consent form · Oct 3, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — De-identified data may be shared with the funding agency as well as other researchers upon request to the Investigational New Drug (IND) Sponsor and Principal Investigator.

Supporting information: Study protocol, Icf

09

Registry details

Key details

Study ID
NCT04726410
Lead sponsor
Jason Sperry
Collaborators
United States Department of Defense
Responsible party
Jason Sperry (Professor of Surgery and Critical Care Medicine, University of Pittsburgh) — Sponsor-investigator
First posted
Jan 27, 2021
Start date
Mar 21, 2022
Primary completion
May 13, 2024
Completion
May 13, 2024
Results posted
Apr 29, 2025
Last update
May 11, 2025

Study contacts

Jason L Sperry, MD
study director · University of Pittsburgh

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Apr 2025. You cannot join it, but the record below documents what was studied.

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