Optimization of Lyophilized Plasma for Use in Combat Casualties
Abstract
Purpose: Hemostatic resuscitation is superior to crystalloid resuscitation in restoring blood volume, correcting coagulopathy, minimizing dysfunctional inflammation, and acidosis. Resuscitation with full volume lyophilized plasma (LP) reduces blood loss, corrects coagulopathy, and decreases inflammation in a swine polytrauma and hemorrhagic shock model. This study compared the efficacy of full volume LP to low volume hypertonic LP. Scope: Prior to in vivo testing, in vivo analysis of the plasma was analyzed for electrolyte content, osmolarity and coagulation factor activity. Twenty swine were anesthetized and subjected to a validated model of polytrauma and hemorrhagic shock. They were randomized with lyophilized plasma (LP) reconstituted to either 100% (100%LP) or half (50%LP) the original plasma volume. Physiologic data were monitored. Blood loss and hematocrit levels were measured. Coagulation status was evaluated utilizing thrombelastography (TEG). Serum and tissue were collected to assess inflammatory markers. Major Findings: 50%LP had higher electrolyte concentrations, osmolarity, and increased coagulation factor activity levels by volume compared to 100%LP. Blood loss, hematocrit, mean arterial pressure and heart rate were not significantly different between groups at any time point. In addition, there were no differences denoted in TEG values. With these finding it is safe to say 50%LP is equally effective as 100%LP. The smaller volume of fluid necessary to reconstitute the 50%LP makes it logistically superior to 100%LP and may reduce adverse effects of large fluid volume resuscitation.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 21, 2013
- Accession Number
- ADA612363
Entities
People
- Claire Sands
- David Hampton
- Elizabeth Rick
- Igor Kremenevskiy
- Jeffrey Barton
- Jerome Differding
- Kate Watson
- Loic Fabricant
- Martin A. Schreiber
- Tim Lee
Organizations
- Oregon Health & Science University