Dried Plasma to Improve Outcomes in Polytrauma, Hemorrhage, and Trauma-Associated Sepsis (TAS): Novel Solutions for the Prolonged Field Care Environment

Abstract

The goal of this project was to determine if plasma is an ideal fluid for resuscitation in the prolonged field care environment for trauma/hemorrhagic shock and trauma-associated sepsis (TAS). The use of a freeze dried (FD) plasma product was compared to fresh frozen plasma as a military-relevant alternative. We hypothesize that FD plasma- based resuscitation after TAS would be equivalent to FFP, superior to Lactated Ringers, and would reduce the endotheliopathy of sepsis (EOS), mitigate vascular and end organ injury, and decrease mortality, in clinically relevant mice and swine models of TAS. We first developed a novel model of prolonged hypotensive resuscitation in mice and found that plasma was superior to Hextend (then the fluid of choice on the battlefield) after hemorrhagic shock and prolonged hypotensive resuscitation. We next used this model to study sepsis. However, we were only able to demonstrate non-inferiority of plasma. In our mouse model of sepsis alone, we found FD-plasma to be noninferior to lactated Ringers with some mechanistic data suggesting an anti-inflammatory effect. In our swine model of combined hemorrhagic shock and sepsis we again demonstrated non-inferiority only of FD-plasma.

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Document Details

Document Type
Technical Report
Publication Date
Jul 01, 2022
Accession Number
AD1191152

Entities

People

  • Rosemary Kozar

Organizations

  • University of Maryland, Baltimore

Tags

DTIC Thesaurus Topics

  • Blood
  • Blood Transfusions
  • Cells
  • Chemical Synthesis
  • Chemistry
  • Combat Casualty Care
  • Data Analysis
  • Health Services
  • Hemorrhage
  • Hemorrhagic Shock
  • Information Science
  • Laboratory Animals
  • Leukocytes
  • Medical Personnel
  • Proteins
  • Therapy

Fields of Study

  • Medicine

Readers

  • Trauma Surgery or Emergency Medicine.