The leading cause of death for children is trauma, with an estimated 2,000 preventable deaths a year caused by bleeding that might have been overcome with optimal care, per the University of Pittsburgh Health Sciences.

The university’s Trauma and Transfusion Medicine Research Center in the Department of Surgery at the University of Pittsburgh School of Medicine plans to change that.

It is launching a clinical trial to test different interventions for critical bleeding in at least 1,000 traumatically injured children in 20 different U.S. pediatric trauma centers, according to the medical center.

The trial, funded by the U.S. Department of Health and Human Services, has a budget for the first five years of $34 million, and that amount could increase.

“This trial will be transformative when it comes to trauma care for children,” trial co-principal investigator Dr. Philip Spinella, co-director of the Pittsburgh center and professor of surgery and critical care medicine, said in a statement. “Not only is trauma the leading cause of death in kids, their mortality rate with life-threatening bleeding is almost twice that of adults. And we think that’s because of delay in recognition and treatment, not that children are less resilient.”

The university said that the researchers will use a “platform trial” in traumatically injured people, including both children and adults. Instead of a single intervention compared to standard care, “platform trials test multiple therapies at once against standard of care” to learn what bundle of care works best and is safest. The trial can be adapted to add or remove treatments “to determine the bundle of care that best improves outcomes.”

“In the time it takes to run a traditional trial, new therapies are introduced while others fall out of favor, so the platform design will ensure the newest and best therapies are put into practice quickly in order to save lives and help close this knowledge gap,” said co-principal investigator Dr. Christine Leeper, assistant professor of surgery and critical care medicine at the university and trauma surgeon at the University of Pittsburgh Medical Center.

The trial will also investigate the safety and efficacy of giving young trauma patients different combinations of whole blood, individual blood components and tranexamic acid to promote clotting. All three have been used in trauma care for children with life-threatening bleeding but not compared in this way.

They also will look at a trauma-induced condition where blood doesn’t clot as it should, to see if children respond differently to the interventions. “This will form the basis for developing a precision transfusion medicine approach to hemorrhagic shock in children,” the release said.

Because during trauma there’s no time to ask for parental informed consent to be part of a clinical trial, that has been waived by the U.S. Food and Drug Administration and an ethics board until the child is stabilized. Parents will also have a way to opt their children out beforehand. Details on that will be announced before the trial starts, the researchers said.