Optimization of Lyophilized Plasma for Use in Combat Casualties

Abstract

Compared to lyophilized plasma (LP) buffered with other acids, LP buffered with ascorbic acid (AA) attenuates systemic inflammation and DNA damage in a combat relevant polytrauma swine model. Despite similar hemodynamic and coagulation responses compared to other acids, it remains unknown whether increasing the concentration of AA will be well tolerated. We hypothesize that different concentrations of AA will not detrimentally affect coagulation and hemodynamic responses following LP resuscitation. Scope: This was a prospective, randomized, blinded animal study. Forty-six female swine were subjected to a validated poly-trauma model and resuscitated with LP. LP was reconstituted to 50% of original volume with sterile water buffered with a randomized concentration of acid: 7.5mM (low AA),15.0mM (medium AA) or 22.5mM (high AA) or 12.0mM hydrochloric acid (HCL) control. Hemodynamic variables, thrombelastography parameters (TEG), blood chemistries (iSTAT) and total blood loss were collected. Significance was defined as p<0.05 with Bonferroni correction for multiple comparisons. Major Findings: No deaths were attributed to LP resuscitation. Hemodynamic variables and base deficit were similar between groups. Thirty-second free bleed, total blood loss, and spun hematocrits were similar between groups following liver injury. TEG demonstrated robust clotting capacity (positive coagulation index) in all groups from 2 to 4 hours following liver injury. No abnormal chemistries were associated with concentration of acid. Therefore, variable AA concentrations are well tolerated physiologically and do not attenuate the pro-coagulant benefits of LP following poly-traumatic injury. Regardless of concentration, AA can safely be used to buffer LP.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2015
Accession Number
AD1002974

Entities

People

  • Belinda Mccully
  • Martin A. Schreiber
  • Samantha Underwood

Organizations

  • Oregon Health & Science University

Tags

DTIC Thesaurus Topics

  • Arteries
  • Blood
  • Blood Cells
  • Blood Chemistry
  • Cardiovascular Physiological Phenomena
  • Casualties
  • Cell Count
  • Chemistry
  • Health Services
  • Hematocrit
  • Hemorrhage
  • Hemorrhagic Shock
  • Hydrochloric Acid
  • Resuscitation
  • Veins
  • Vitamin C

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Prostate Cancer Biology.
  • Trauma Surgery or Emergency Medicine.