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...
Gespeichert in:
| Veröffentlicht in: | The Journal of surgical research 2021-03, Vol.259, p.55-61 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 61 |
|---|---|
| container_issue | |
| container_start_page | 55 |
| container_title | The Journal of surgical research |
| container_volume | 259 |
| creator | Stettler, Gregory R. Moore, Ernest E. Nunns, Geoffrey R. Kelher, Marguerite Banerjee, Anirban Silliman, Christopher C. |
| description | 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 |
| doi_str_mv | 10.1016/j.jss.2020.10.022 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7897253</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022480420307678</els_id><sourcerecordid>2467618545</sourcerecordid><originalsourceid>FETCH-LOGICAL-c451t-aa6c246a76ac2d3d5150959e58457cbd152086521dfe3552dd782b1bcc0fbbf43</originalsourceid><addsrcrecordid>eNp9UV1LwzAUDaK4-fEDfJE--tKZpE3TIgg65gdMfFDxRQhpcrtltM1M1oH_3pTNoS8-hXvvOeee3IPQGcEjgkl2uRgtvB9RTPt6hCndQ0OCCxbnGU_20RCHVpzmOB2gI-8XONQFTw7RIEkoz3mRDdHHpKpArXxkq-i2tlZHY9ssbQtt6MlWR-9zW8N2ZNpIRk9WQ93DX2ANDqJXJ7tGxo-t7hT0dDnraruUq_nXCTqoZO3hdPseo7e7yev4IZ4-3z-Ob6axShlZxVJmiqaZ5JlUVCeaERY-UQDLU8ZVqQmjOM8YJbqChDGqNc9pSUqlcFWWVZoco-uN7rIrG9AqmHeyFktnGum-hJVG_J20Zi5mdi14XnDKkiBwsRVw9rMDvxKN8QrqWrZgOy-CO56RnKUsQMkGqpz13kG1W0Ow6FMRCxFSEX0qfStEEDjnv_3tGD8xBMDVBgDhSmsDTnhloA33NC6kI7Q1_8h_A9i6njs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2467618545</pqid></control><display><type>article</type><title>Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Stettler, Gregory R. ; Moore, Ernest E. ; Nunns, Geoffrey R. ; Kelher, Marguerite ; Banerjee, Anirban ; Silliman, Christopher C.</creator><creatorcontrib>Stettler, Gregory R. ; Moore, Ernest E. ; Nunns, Geoffrey R. ; Kelher, Marguerite ; Banerjee, Anirban ; Silliman, Christopher C.</creatorcontrib><description>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 < 0.01). The addition of tPA resulted in a severe coagulopathy (MA 24.5 mm versus 41 mm and LY30 52.8% versus 2.4%, P < 0.03 for all). The addition of 4U of WB improved clot strength compared to TIC + tPA (P = 0.03). No individual blood component resulted in improved fibrinolysis (P > 0.7). Cryoprecipitate improved R-time (7.5 versus 11.9 min, P < 0.01), angle (56.8 versus 30.2°) and MA (49 mm versus 36.25 mm), while platelets improved MA (44 mm versus 36.25 mm) compared to TIC + tPA (P < 0.03 for all).
No single blood component or volume of whole blood led to attenuation of tPA-mediated fibrinolysis in an in vitro model of TIC. Cryoprecipitate was the most effective at improving coagulation function.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2020.10.022</identifier><identifier>PMID: 33278796</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Coagulation Disorders - blood ; Blood Coagulation Disorders - diagnosis ; Blood Coagulation Disorders - etiology ; Blood Coagulation Disorders - therapy ; Blood component therapy ; Blood Component Transfusion - methods ; Healthy Volunteers ; Humans ; Hyperfibrinolysis ; In Vitro Techniques ; Resuscitation - methods ; Thrombelastography ; Tissue Plasminogen Activator - blood ; Tissue Plasminogen Activator - metabolism ; Trauma Severity Indices ; Trauma-induced coagulopathy ; Whole blood ; Wounds and Injuries - blood ; Wounds and Injuries - complications ; Wounds and Injuries - diagnosis</subject><ispartof>The Journal of surgical research, 2021-03, Vol.259, p.55-61</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-aa6c246a76ac2d3d5150959e58457cbd152086521dfe3552dd782b1bcc0fbbf43</citedby><cites>FETCH-LOGICAL-c451t-aa6c246a76ac2d3d5150959e58457cbd152086521dfe3552dd782b1bcc0fbbf43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022480420307678$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33278796$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stettler, Gregory R.</creatorcontrib><creatorcontrib>Moore, Ernest E.</creatorcontrib><creatorcontrib>Nunns, Geoffrey R.</creatorcontrib><creatorcontrib>Kelher, Marguerite</creatorcontrib><creatorcontrib>Banerjee, Anirban</creatorcontrib><creatorcontrib>Silliman, Christopher C.</creatorcontrib><title>Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>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 < 0.01). The addition of tPA resulted in a severe coagulopathy (MA 24.5 mm versus 41 mm and LY30 52.8% versus 2.4%, P < 0.03 for all). The addition of 4U of WB improved clot strength compared to TIC + tPA (P = 0.03). No individual blood component resulted in improved fibrinolysis (P > 0.7). Cryoprecipitate improved R-time (7.5 versus 11.9 min, P < 0.01), angle (56.8 versus 30.2°) and MA (49 mm versus 36.25 mm), while platelets improved MA (44 mm versus 36.25 mm) compared to TIC + tPA (P < 0.03 for all).
No single blood component or volume of whole blood led to attenuation of tPA-mediated fibrinolysis in an in vitro model of TIC. Cryoprecipitate was the most effective at improving coagulation function.</description><subject>Blood Coagulation Disorders - blood</subject><subject>Blood Coagulation Disorders - diagnosis</subject><subject>Blood Coagulation Disorders - etiology</subject><subject>Blood Coagulation Disorders - therapy</subject><subject>Blood component therapy</subject><subject>Blood Component Transfusion - methods</subject><subject>Healthy Volunteers</subject><subject>Humans</subject><subject>Hyperfibrinolysis</subject><subject>In Vitro Techniques</subject><subject>Resuscitation - methods</subject><subject>Thrombelastography</subject><subject>Tissue Plasminogen Activator - blood</subject><subject>Tissue Plasminogen Activator - metabolism</subject><subject>Trauma Severity Indices</subject><subject>Trauma-induced coagulopathy</subject><subject>Whole blood</subject><subject>Wounds and Injuries - blood</subject><subject>Wounds and Injuries - complications</subject><subject>Wounds and Injuries - diagnosis</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UV1LwzAUDaK4-fEDfJE--tKZpE3TIgg65gdMfFDxRQhpcrtltM1M1oH_3pTNoS8-hXvvOeee3IPQGcEjgkl2uRgtvB9RTPt6hCndQ0OCCxbnGU_20RCHVpzmOB2gI-8XONQFTw7RIEkoz3mRDdHHpKpArXxkq-i2tlZHY9ssbQtt6MlWR-9zW8N2ZNpIRk9WQ93DX2ANDqJXJ7tGxo-t7hT0dDnraruUq_nXCTqoZO3hdPseo7e7yev4IZ4-3z-Ob6axShlZxVJmiqaZ5JlUVCeaERY-UQDLU8ZVqQmjOM8YJbqChDGqNc9pSUqlcFWWVZoco-uN7rIrG9AqmHeyFktnGum-hJVG_J20Zi5mdi14XnDKkiBwsRVw9rMDvxKN8QrqWrZgOy-CO56RnKUsQMkGqpz13kG1W0Ow6FMRCxFSEX0qfStEEDjnv_3tGD8xBMDVBgDhSmsDTnhloA33NC6kI7Q1_8h_A9i6njs</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Stettler, Gregory R.</creator><creator>Moore, Ernest E.</creator><creator>Nunns, Geoffrey R.</creator><creator>Kelher, Marguerite</creator><creator>Banerjee, Anirban</creator><creator>Silliman, Christopher C.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210301</creationdate><title>Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy</title><author>Stettler, Gregory R. ; Moore, Ernest E. ; Nunns, Geoffrey R. ; Kelher, Marguerite ; Banerjee, Anirban ; Silliman, Christopher C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-aa6c246a76ac2d3d5150959e58457cbd152086521dfe3552dd782b1bcc0fbbf43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood Coagulation Disorders - blood</topic><topic>Blood Coagulation Disorders - diagnosis</topic><topic>Blood Coagulation Disorders - etiology</topic><topic>Blood Coagulation Disorders - therapy</topic><topic>Blood component therapy</topic><topic>Blood Component Transfusion - methods</topic><topic>Healthy Volunteers</topic><topic>Humans</topic><topic>Hyperfibrinolysis</topic><topic>In Vitro Techniques</topic><topic>Resuscitation - methods</topic><topic>Thrombelastography</topic><topic>Tissue Plasminogen Activator - blood</topic><topic>Tissue Plasminogen Activator - metabolism</topic><topic>Trauma Severity Indices</topic><topic>Trauma-induced coagulopathy</topic><topic>Whole blood</topic><topic>Wounds and Injuries - blood</topic><topic>Wounds and Injuries - complications</topic><topic>Wounds and Injuries - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stettler, Gregory R.</creatorcontrib><creatorcontrib>Moore, Ernest E.</creatorcontrib><creatorcontrib>Nunns, Geoffrey R.</creatorcontrib><creatorcontrib>Kelher, Marguerite</creatorcontrib><creatorcontrib>Banerjee, Anirban</creatorcontrib><creatorcontrib>Silliman, Christopher C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stettler, Gregory R.</au><au>Moore, Ernest E.</au><au>Nunns, Geoffrey R.</au><au>Kelher, Marguerite</au><au>Banerjee, Anirban</au><au>Silliman, Christopher C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>259</volume><spage>55</spage><epage>61</epage><pages>55-61</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>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 < 0.01). The addition of tPA resulted in a severe coagulopathy (MA 24.5 mm versus 41 mm and LY30 52.8% versus 2.4%, P < 0.03 for all). The addition of 4U of WB improved clot strength compared to TIC + tPA (P = 0.03). No individual blood component resulted in improved fibrinolysis (P > 0.7). Cryoprecipitate improved R-time (7.5 versus 11.9 min, P < 0.01), angle (56.8 versus 30.2°) and MA (49 mm versus 36.25 mm), while platelets improved MA (44 mm versus 36.25 mm) compared to TIC + tPA (P < 0.03 for all).
No single blood component or volume of whole blood led to attenuation of tPA-mediated fibrinolysis in an in vitro model of TIC. Cryoprecipitate was the most effective at improving coagulation function.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33278796</pmid><doi>10.1016/j.jss.2020.10.022</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-4804 |
| ispartof | The Journal of surgical research, 2021-03, Vol.259, p.55-61 |
| issn | 0022-4804 1095-8673 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7897253 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Blood Coagulation Disorders - blood Blood Coagulation Disorders - diagnosis Blood Coagulation Disorders - etiology Blood Coagulation Disorders - therapy Blood component therapy Blood Component Transfusion - methods Healthy Volunteers Humans Hyperfibrinolysis In Vitro Techniques Resuscitation - methods Thrombelastography Tissue Plasminogen Activator - blood Tissue Plasminogen Activator - metabolism Trauma Severity Indices Trauma-induced coagulopathy Whole blood Wounds and Injuries - blood Wounds and Injuries - complications Wounds and Injuries - diagnosis |
| title | Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T05%3A33%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20Blood%20Components%20and%20Whole%20Blood%20in%20a%20Model%20of%20Severe%20Trauma-Induced%20Coagulopathy&rft.jtitle=The%20Journal%20of%20surgical%20research&rft.au=Stettler,%20Gregory%20R.&rft.date=2021-03-01&rft.volume=259&rft.spage=55&rft.epage=61&rft.pages=55-61&rft.issn=0022-4804&rft.eissn=1095-8673&rft_id=info:doi/10.1016/j.jss.2020.10.022&rft_dat=%3Cproquest_pubme%3E2467618545%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2467618545&rft_id=info:pmid/33278796&rft_els_id=S0022480420307678&rfr_iscdi=true |