Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy

Plasma resuscitation ameliorates hyperfibrinolysis (HF) and trauma-induced coagulopathy (TIC). However, the use of other blood components to reduce HF has not been evaluated. Therefore, our aim was to determine the effect of individual blood components and whole blood (WB) on an in vitro model of se...

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Veröffentlicht in:The Journal of surgical research 2021-03, Vol.259, p.55-61
Hauptverfasser: Stettler, Gregory R., Moore, Ernest E., Nunns, Geoffrey R., Kelher, Marguerite, Banerjee, Anirban, Silliman, Christopher C.
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Sprache:eng
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Zusammenfassung:Plasma resuscitation ameliorates hyperfibrinolysis (HF) and trauma-induced coagulopathy (TIC). However, the use of other blood components to reduce HF has not been evaluated. Therefore, our aim was to determine the effect of individual blood components and whole blood (WB) on an in vitro model of severe HF/TIC. A “TIC” solution was made with 1:1 dilution of WB with saline and exacerbated with tissue plasminogen activator (tPA). Components were added in proportions equivalent to the thromboelastography (TEG) based goal-directed resuscitation used at our institution. Whole blood was added at proportions equal to what has been transfused in injured patients. Samples (n = 9) underwent citrated native and tPA-challenge (75 ng/mL) TEG with analysis of R-time, angle, MA, and LY30. Statistical analyses were completed employing the nonparametric Kruskal–Wallis and Dunn’s multiple comparisons tests. TIC solution, when compared to control, had a decrease in clot strength (MA 41 mm versus 51.5 mm, P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2020.10.022