Modulating the endotheliopathy of trauma: Factor concentrate versus fresh frozen plasma

The Journal of Trauma and Acute Care Surgery
S PatiMartin A Schreiber

Abstract

Transfusion of balanced ratios of plasma to platelets and red blood cells has been shown to reduce early death from exsanguination in trauma patients. Aside from hemostasis, recent work has shown that plasma reduces vascular endothelial permeability, inflammation, and organ edema after hemorrhagic shock (HS), all components of the endotheliopathy of trauma. We hypothesized that Kcentra could have protective effects on the endotheliopathy of trauma comparable with fresh frozen plasma (FFP). In vitro, endothelial cell (EC) barrier function was assessed by measuring changes in transendothelial electrical resistance for Kcentra, FFP, and albumin. In vivo, a modified Miles assay was used on mice to study the effects of Kcentra, FFP, and albumin on vascular permeability induced by VEGF-A. The same groups were studied in a second in vivo model of pulmonary vascular leak induced by HS and laparotomy. The identification of proteins in Kcentra was assessed by liquid chromatography/mass spectrometry. We found that FFP and Kcentra inhibit EC permeability. We also found that Kcentra and FFP have equivalent capacity to restore EC adherens junction breakdown induced by VEGF-A. In vivo, we found that Kcentra and FFP, but not albumin, significa...Continue Reading

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Citations

Sep 17, 2016·Anesthesia and Analgesia·James WinearlsJohn F Fraser
Oct 8, 2016·Critical Care : the Official Journal of the Critical Care Forum·David N NaumannSam D Hutchings
Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Lawrence N DiebelDavid M Liberati
Jul 26, 2018·The New England Journal of Medicine·Jason L SperryUNKNOWN PAMPer Study Group
Apr 14, 2019·Transfusion·Jennifer M GurneyLeopoldo C Cancio
Apr 16, 2019·Journal of Thrombosis and Haemostasis : JTH·Lucy Z KornblithMitchell J Cohen
Nov 23, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Erika Gonzalez RodriguezCharles E Wade
Jan 29, 2020·Platelets·Paul VulliamyMatthew D Neal
Mar 10, 2019·Critical Care : the Official Journal of the Critical Care Forum·Elissa M Milford, Michael C Reade
Oct 22, 2016·The Journal of Trauma and Acute Care Surgery·Zhanglong PengRosemary A Kozar
May 4, 2018·Frontiers in Medicine·Stefano Barelli, Lorenzo Alberio
May 10, 2017·Internal and Emergency Medicine·Stefano GiordanoPaolo Simioni
Nov 20, 2020·Acute Medicine & Surgery·Hiroyuki OtsukaSadaki Inokuchi
Apr 3, 2021·The Journal of Trauma and Acute Care Surgery·Mark BarryShibani Pati
Jun 1, 2021·Frontiers in Veterinary Science·Edward S Cooper, Deborah C Silverstein
Jul 17, 2021·Transfusion·Henry T PengAndrew Beckett
Sep 11, 2021·Blood Advances·Derek J B KleinveldUNKNOWN BloodNet

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