Interventional Vitamin C A Strategy for Attenuation of Coagulopathy and Inflammation in Hemorrhagic Trauma and Shock

Abstract

This is a novel study of high dose parenteral vitamin C (VitC) in a swine model of combined hemorrhagic shock and tissue trauma that simulates the course of a combat casualty by exhibiting the components of the lethal triad of acidosis, coagulopathy and hypothermia. The major goal of Year1 of this project was to determine the effective parenteral dose of VitC. We successfully developed a reproducible traumatic injury/shock hemorrhage model in swine. This model produced significant platelet dysfunction and a reduction in global coagulation. Histological staining (H and E) of lung showed extensive hemorrhage, septal edema, protein leak and exuberant infiltration of inflammatory cells. Significant hemorrhage and cellular damage were also evident in liver and kidney sections. Treatment with VitC (200mg/kg) was associated with a lower degree of histological tissue injury and a significantly reduced ALI score. Treatment with VitC also reduced the expression of pro-inflammatory mediators in lungs, liver and kidneys. In addition, VitC attenuated the mRNA expression of plasminogen activated inhibitor-1 and tissue factor, and increased mRNA expression of thrombomodulin. Our data suggest that intravenous VitC at200mg/kg appears to significantly ameliorate the inflammatory status and trauma induced coagulopathy in this model.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2016
Accession Number
AD1029639

Entities

People

  • Ramesh Natarajan

Organizations

  • Virginia Commonwealth University

Tags

DTIC Thesaurus Topics

  • Blood Flow
  • Chemistry
  • Health Services
  • Hemorrhage
  • Hemorrhagic Shock
  • Mass Spectrometry
  • Medical Personnel
  • Military Medicine
  • Proteins
  • Public Health
  • Resuscitation
  • Therapy
  • Vitamin C

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Immunology and Pathology