Plasma supplementation is beneficial for coagulation during severe hemorrhagic shock

Lucas, Charles E.; Ledgerwood, Anna M.; Saxe, Jonathan M.; Dombi, George W.; Lucas, William F.

doi:10.1016/s0002-9610(97)89618-3

Cited by 33 publications

(28 citation statements)

References 3 publications

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“…In this model, fibrinogen concentration initially decreased about 25% after hemorrhage and LR resuscitation on day 1, rose to twice the prehemorrhage levels on day 2, and remained at the elevated level on days 3, 4, and 5. This dynamic profile is similar to that previously reported in a canine model (16,17) and trauma patients (9, 18) after severe hemorrhagic shock. In dogs with hemorrhagic shock followed by LR resuscitation, Lucas et al (16) reported that fibrinogen levels decreased after hemorrhage and resuscitation and rose the next day.…”

Section: Discussionsupporting

confidence: 90%

“…This dynamic profile is similar to that previously reported in a canine model (16,17) and trauma patients (9, 18) after severe hemorrhagic shock. In dogs with hemorrhagic shock followed by LR resuscitation, Lucas et al (16) reported that fibrinogen levels decreased after hemorrhage and resuscitation and rose the next day. In patients with hemorrhagic shock and blood transfusion, Harrigan et al (9) reported that fibrinogen levels fell after surgery, increased and plateaued on day 2 after surgery, and remained at the plateau values even on day 25.…”

Section: Discussionsupporting

confidence: 90%

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Daily Profiles of Fibrinogen Metabolism for 5 Days Following Hemorrhage and Lactated Ringer’s Resuscitation in Pigs

Martini

Chung²,

Dubick³

et al. 2012

Shock

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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 through 5 (all P < 0.05); fibrinogen breakdown in H was elevated on days 1 and 2 but returned to control values afterward. Hemorrhage caused acute decreases in fibrinogen concentration and clot strength, followed by an increase in fibrinogen concentration and recovery of clot strength. The increase in fibrinogen appeared primarily due to a sustained increase in fibrinogen synthesis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Daily Profiles of Fibrinogen Metabolism for 5 Days Following Hemorrhage and Lactated Ringer’s Resuscitation in Pigs

Martini

Chung²,

Dubick³

et al. 2012

Shock

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“…Lucas and Ledgerwood published a study showing decreased transfusion of plasma during massive resuscitation exacerbated coagulopathy in trauma patients [ 14 ]. Expanding on the work of Lucas and Ledgerwood, numerous studies of trauma patients in the late 1990s reported that mortality improved in patients receiving higher ratios of FFP relative to PRBC [ 15 -17 ].…”

Section: Historical Backgroundmentioning

confidence: 99%

Massive Transfusion Protocols

Moren

Underwood

Schreiber

2016

Trauma Induced Coagulopathy

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“…Thus, these are also not to be expected in the near future. Nevertheless, one study in bleeding patients also clearly shows that too late correction of coagulopathy is associated with increased blood loss and the need for transfusion of various blood components [17]. Furthermore, a study conducted in cirrhotic patients with active variceal bleeding showed that hypocoagulability is associated with early re-bleeding [18].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of Perioperative Dilutional Coagulopathy Using the ROTEM® Analyzer: Basic Principles and Clinical Examples

Innerhofer¹,

Streif²,

Kühbacher³

et al. 2004

Transfus Med Hemother

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Recent changes in quality of transfusion supply, transfusion triggers as well as fluid therapy promote the development of dilutional coagulopathy. Nevertheless, up to now guidelines generally assume presence of hypocoagulability when more than one individual circulating blood volume is lost. This might be true for some patients under some conditions but is not necessarily true for every patient. Routine coagulation tests are insufficient in predicting increased bleeding and, moreover, only available after an unacceptable time delay. Therefore, the occurrence of diffuse microvascular bleeding is often used as clinical sign to start hemostatic therapy. However, such severe derangement of hemostasis might lead to the development of secondary tissue damage and frequently is unresponsive to conventional treatment. Coagulopathy occurring during extensive surgery or after polytrauma can be detected and treated early when using the ROTEM monitoring. Recent data showing a direct beneficial effect of hemostatic therapy on blood loss and final outcome are scarce. However, evidence exists that the amount of blood loss, the presence of coagulopathy, and the number of transfusions needed are associated with poor outcome in bleeding patients. Although manifold articles have been published already using thrombelastography for various indications (MEDLINE research ‘thrombelastography’, 2,022 articles), further data are needed to confirm the clinical experience that this technique is an excellent tool for safe patient management.

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Plasma supplementation is beneficial for coagulation during severe hemorrhagic shock

Cited by 33 publications

References 3 publications

Daily Profiles of Fibrinogen Metabolism for 5 Days Following Hemorrhage and Lactated Ringer’s Resuscitation in Pigs

Daily Profiles of Fibrinogen Metabolism for 5 Days Following Hemorrhage and Lactated Ringer’s Resuscitation in Pigs

Massive Transfusion Protocols

Monitoring of Perioperative Dilutional Coagulopathy Using the ROTEM® Analyzer: Basic Principles and Clinical Examples

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