Plasma supplementation is beneficial for coagulation during severe hemorrhagic shock

American Journal of Surgery
C E LucasW F Lucas

Abstract

Hemorrhagic shock (HS) often causes coagulopathy due, in part, to decreased coagulation proteins. This study assessed the efficacy of fresh frozen plasma (FFP) in preventing this coagulopathy following a canine model of HS designed to mimic bleeding with shock as seen in the emergency department followed by bleeding without shock as seen during operation for control of bleeding. Twenty-two dogs had acute HS for 2 hours followed by resuscitation with red blood cells (RBC) plus lactated ringers (LR) or RBC and LR with FFP. After resuscitation, bleeding was continued for 1 hour while intravenous replacement of RBC and LR with or without FFP was provided. Baseline, postshock, postresuscitation, post-1 hour exchange, postoperative day one and day two measurements included coagulation Factors I, II, V, VII, VIII, and X, and the prothrombin (PT), partial thromboplastin (PTT), and thrombin times (TT). Baseline, postshock, and postresuscitation hemodynamic responses, coagulation factor levels, and coagulation times were similar for both groups. By contrast, the 1-hour postexchange factors were depleted in the LR dogs compared to the FFP dogs. This depletion correlated with prolonged PT, PTT, and TT in the LR dogs (mean 14, 35, and 8 sec...Continue Reading

References

Oct 1, 1989·The Journal of Trauma·C HarriganA M Ledgerwood
Oct 1, 1985·Annals of Surgery·D J MartinD Grabow
Aug 1, 1982·Annals of Surgery·C E LucasE F Mammen

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Citations

Mar 2, 2011·Seminars in Interventional Radiology·Anthony D GoeiDavid Sacks
Sep 5, 2009·Current Opinion in Critical Care·Timothy C Nunez, Bryan A Cotton
Aug 2, 2012·The Surgical Clinics of North America·John ChovanesTimothy C Nunez
Feb 7, 2012·Neurosurgery·Mathieu LarocheGeoffrey T Manley
Jun 20, 2012·The Journal of Trauma and Acute Care Surgery·Wenjun Z MartiniLorne H Blackbourne
Jun 15, 2012·The Journal of Trauma and Acute Care Surgery·Anna M Ledgerwood, William Blaisdell
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Charles E Lucas, Anna M Ledgerwood
Aug 17, 2021·Frontiers in Veterinary Science·Kelly Hall, Kenneth Drobatz
Sep 22, 2009·Transfusion Medicine Reviews·Lynn G StansburyJohn R Hess

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