Red Blood Cells Accelerate the Onset of Clot Formation in Polytrauma and Hemorrhagic Shock
Abstract
Background: Hemorrhage and coagulopathy are major contributors to death after trauma. The contribution of red blood cells (RBCs) in correcting coagulopathy is poorly understood. Current methods of measuring coagulopathy may fail to accurately characterize in vivo clotting. We aimed to determine the effect of RBCs on clotting parameters by comparing resuscitation regimens containing RBCs and plasma with those containing plasma alone. Methods: Thirty-two Yorkshire swine were anesthetized, subjected to a complex model of polytrauma and hemorrhagic shock, and resuscitated with either fresh frozen plasma, lyophilized plasma (LP), or 1:1 ratios of fresh frozen plasma:packed RBC (PRBC) or LP:PRBC. Activated clotting time, prothrombin time, partial thromboplastin time, and thrombelastography (TEG) were performed at 1 hour, 2 hours, 3 hours, and 4 hours after resuscitation. Results: Animals treated with 1:1 LP:PRBC had less blood loss than the other groups ( p less than 0.05). The activated clotting time was shorter in the 1:1 groups when compared with the pure plasma groups at all time points ( p less than 0.05). The 1:1 groups had shorter TEG R times (time to onset of clotting) at 1 hour, 3 hours, and 4 hours compared with pure plasma groups ( p less than 0.05). Other TEG parameters did not differ between groups. Partial thromboplastin time was shorter in the pure plasma groups than the 1:1 groups at all time points ( p less than 0.05). Conclusions: Whole blood assays reveal that RBCs accelerate the onset of clot formation. Coagulation assays u
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 01, 2010
- Accession Number
- ADA629497
Entities
People
- Jerome A. Differding
- Jill L. Sondeen
- John B Holcomb
- Karen A. Zink
- Martin A. Schreiber
- Nicholas J. Spoerke
- Patrick J. Muller
- Philbert Y. Van
- S. D. Cho
- Z. A. Karahan
Organizations
- United States Army Institute of Surgical Research