Troubling Article about Columbia...

[starsop93]

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Check this out: http://www.huffingtonpost.com/2009/10/07/government-orders-columbi_n_312536.html

While there is the usual ignorance about the nature of clinical trials, it is troubling how difficult it was to halt the trial after questions were raised. I always wondered why Bennett-Guerrero left.

 

[coprolalia]

Let me guess, starsop93... You're still waiting to hear about an interview at Columbia, right?

-copro

 

[deleted87051]

Reminds me of a polyheme study out here. Ostensibly to compare in field administration of polyheme to saline for resuscitation of hemorrhagic shock. Problem was that even after arrival in the hospital, PRBCs could not be given until a predetermined amount of polyheme was administered first. In some cases, this delayed administration of lifegiving blood. Thankfully this trial was ended early. The patients were enrolled through EMS calls and were not consented because they were generally unable to give consent. The ethics of some trials are tricky.

 

[WholeLottaGame7]

Reminds me of a polyheme study out here. Ostensibly to compare in field administration of polyheme to saline for resuscitation of hemorrhagic shock. Problem was that even after arrival in the hospital, PRBCs could not be given until a predetermined amount of polyheme was administered first. In some cases, this delayed administration of lifegiving blood. Thankfully this trial was ended early. The patients were enrolled through EMS calls and were not consented because they were generally unable to give consent. The ethics of some trials are tricky.

Yeah, with the polyheme trial, you could opt out but you had to have heard about the trial at a community meeting and wear some sort of bracelet all the time, and who's going to do that? Not to mention the issue nimbus brought up with not getting post-hospital transfusions for awhile.

 

[WholeLottaGame7]

As for the article itself, I don't find it terribly enlightening as to what is going on. Part of the time it seems like a vendetta by those two doctors with the gov't agreeing that there's nothing there. Then Columbia and the gov't both backtrack and become re-concerned. Was Bennett-Guerrero intentionally being deceitful in order to keep his funding, or was he upfront and legit, and these complications are not drug-related? It sounds like the hospital and the gov't have both waffled, and they've seen the data, so how are we supposed to be able to tell?

 

[powermd]

As for the article itself, I don't find it terribly enlightening as to what is going on. Part of the time it seems like a vendetta by those two doctors with the gov't agreeing that there's nothing there. Then Columbia and the gov't both backtrack and become re-concerned. Was Bennett-Guerrero intentionally being deceitful in order to keep his funding, or was he upfront and legit, and these complications are not drug-related? It sounds like the hospital and the gov't have both waffled, and they've seen the data, so how are we supposed to be able to tell?

I wonder when exactly this study was done, because in none of my cardiac or CTICU months (at CPMC) did I participate in, or hear about a fluid study. Hextend is used in our ORs somewhat frequently, but we hardly ever gave more than 1L because of the concern for coagulopathy. In the reading I did at the time, it seemed you had to give 5 liters before coagulopathy developed. Albumin was used in our ORs for big fluid loss cases all the time. That stuff flows like water in the cardiac rooms and CTICU. I don't think I ever used Hetastarch.