Plasma supplementation is beneficial for coagulation during severe hemorrhagic shock.

Abstract:

BACKGROUND: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. METHODS: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). RESULTS: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 seconds) compared to FFP dogs (9, 24, and 6 seconds). CONCLUSIONS:Severe HS beyond one blood volume exceeds the interstitial stores of coagulation protein, thus necessitating FFP supplementation.

journal_name

Am J Surg

authors

Lucas CE,Ledgerwood AM,Saxe JM,Dombi G,Lucas WF

doi

10.1016/S0002-9610(97)89618-3

subject

Has Abstract

pub_date

1996-04-01 00:00:00

pages

399-404

issue

4

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(97)89618-3

journal_volume

171

pub_type

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