Daily profiles of fibrinogen metabolism for 5 days following hemorrhage and lactated ringer's resuscitation in pigs

Shock
Wenjun Z MartiniLorne H Blackbourne

Abstract

This study's objective was to investigate the daily dynamics of fibrinogen metabolism and coagulation function for 5 days after hemorrhagic shock in pigs. Sixteen pigs were randomized into the control (C) and the hemorrhage (H) groups. On day 1, hemorrhage was induced in H by bleeding 35% of the estimated total blood volume, followed by resuscitation with lactated Ringer's solution at three times the bled volume. Then, a primed constant infusion of stable isotopes was performed in both groups daily for 5 days to measure changes in fibrinogen metabolism, together with changes in hemodynamics and coagulation function. Hemorrhage caused a decrease in mean arterial pressure and an increase in heart rate. Fluid resuscitation corrected these changes. Compared with baseline day 1, fibrinogen levels in H were decreased to 76% ± 6% by hemorrhage and resuscitation on day 1, increased to 217% ± 16% on day 2, and remained elevated afterward; clot strength in H was decreased by hemorrhage on day 1 and returned to baseline values on day 2 and afterward. Compared with day 1 control value (1.3 ± 0.1 mg/kg per hour), fibrinogen synthesis in H was increased to 3.6 ± 0.1, 5.1 ± 0.5, 2.6 ± 0.4, 2.7 ± 0.5, and 2.3 ± 0.3 mg/kg per hour on days 1 thr...Continue Reading

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Citations

Mar 14, 2013·Shock·Daniel N DarlingtonMichael A Dubick
Jul 17, 2013·Shock·Frank HildebrandMartijn van Griensven
Sep 25, 2015·The Journal of Trauma and Acute Care Surgery·Wenjun Z Martini, Michael A Dubick
Aug 15, 2013·The Journal of Trauma and Acute Care Surgery·John B HolcombUNKNOWN PROMMTT Study Group

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