Abstract
To investigate hemostatic effects of supplementary factor XIII and desmopressin (DDAVP) in resuscitation of uncontrolled bleeding. Fifty-four rabbits were randomized in nine groups: G1: Sham; G2: FXIII and normotensive resuscitation (NBP); G3: FXIII and permissive hypotension (PH) (MAP 60% baseline); G4: FXIII/DDAVP/NBP; G5: FXIII/DDAVP/PH; G6: NBP only; G7: FXIII no hemorrhage; G8: FXIII/DDAVP no hemorrhage; G9: PH only. Thromboelastometry and intra-abdominal blood loss were assessed. Scanning electron microscopy (EM) of the clots was performed. Compared to Sham, only G8 (FXIII/DDAVP w/o hemorrhage) showed clotting time (CT) significantly lower (p<0.05). NBP alone (G6) resulted in significantly prolonged CT compared to G2, G3 and G5 (p<0.05). Similarly, median alpha angle was significantly larger in G3,4,5, and 9 compared to G6 (p<0.05). Area under the curve was significantly greater in G5 than G2. Intra-abdominal blood loss was lower in G5 and G9 compared to G2 and G6. FXIII/DDAVP and PH resulted in more robust fibrin mesh by EM. Normotensive resuscitation provokes more bleeding and worsens coagulation compared to pH, that is partially reversed by factor XIII and desmopressin. FXIII and DDAVP can synergistically improve coagu...Continue Reading
References
Oct 1, 1980·Thrombosis Research·P M Mannucci, L Rota
Jun 19, 2002·Blood·Kathleen E BrummelKenneth G Mann
Jun 19, 2003·The Journal of Trauma·Karim BrohiTimothy Coats
Jul 12, 2003·The Journal of Trauma·Jana B A MacLeodMary Murtha
Apr 1, 1964·Archives of Biochemistry and Biophysics·L LORAND, K KONISHI
Jul 30, 2004·Anesthesia and Analgesia·Vance G NielsenThomas M Burch
Feb 9, 2007·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Vance G NielsenWilliam L Holman
Feb 14, 2007·The Journal of Trauma·John B HolcombJohn R Hess
Jan 13, 2009·Injury·L M G GeeraedtsJ P M Frölke
Jan 15, 2009·Haemophilia : the Official Journal of the World Federation of Hemophilia·L Hsieh, D Nugent
Sep 19, 2009·Anesthesia and Analgesia·Csilla JámborWolfgang C Korte
Dec 19, 2009·Haemophilia : the Official Journal of the World Federation of Hemophilia·J LusherD Nugent
Jan 13, 2010·The Journal of Trauma·Joao B Rezende-NetoJose R Cunha-Melo
May 1, 2010·Thrombosis and Haemostasis·Oliver M TheusingerDonat R Spahn
Jun 18, 2010·Lancet·UNKNOWN CRASH-2 trial collaboratorsSurakrant Yutthakasemsunt
Dec 21, 2010·Anesthesiology·Tao LiLiangming Liu
Dec 17, 2011·The Journal of Trauma·Sandro B RizoliHomer C Tien
Dec 3, 2011·Annals of Surgery·Mitchell Jay CohenJean Francois Pittet
Dec 27, 2011·Thrombosis Research·Daniel FrithKarim Brohi
Dec 27, 2011·Thrombosis Research·Zsuzsa BagolyLászló Muszbek
Aug 2, 2012·The Surgical Clinics of North America·Mitchell Jay Cohen
Aug 30, 2012·Transfusion·Jerrold H Levy, Charles Greenberg
Jan 12, 2013·Blood·John W Weisel, Rustem I Litvinov
Aug 15, 2013·The Journal of Trauma and Acute Care Surgery·Mitchell Jay CohenUNKNOWN PROMMTT Study Group
Nov 22, 2013·The Journal of Trauma and Acute Care Surgery·Christopher Rees PortaMatthew J Martin