Lyophilized plasma for resuscitation in a swine model of severe injury

Nicholas Spoerke, Karen Zink, S. David Cho, Jerome Differding, Patrick Muller, Ayhan Karahan, Jill Sondeen, John B. Holcomb, Martin Schreiber

    Research output: Contribution to journalArticle

    46 Citations (Scopus)

    Abstract

    Hypothesis: Lyophilized plasma (LP) is as safe and effective as fresh frozen plasma (FFP) for resuscitation after severe trauma. Design: Multicenter animal study. Setting: Animal laboratories, 2 level I trauma centers. Participants: Thirty-two Yorkshire crossbred swine. Interventions: Lyophilized plasma was analyzed for factor levels and clotting activity before lyophilization and after reconstitution. Swine were subjected to complex multiple trauma including extremity fracture, hemorrhage, severe liver injury, acidosis, and hypothermia. They were then resuscitated with FFP, LP, FFP and packed red blood cells (PRBCs) in a ratio of 1:1, or 1:1 LP and PRBCs. Main Outcome Measures: Residual clotting activity of LP after reconstitution, swine mortality, hemodynamic measures, total blood loss, coagulation profiles, and inflammatory measures. Results: Lyophilization decreased clotting factor activity by an average of 14%. Survival and heart rate were similar between all groups. Swine resuscitated with LP had equivalent or higher mean arterial pressures. Swine treated with LP had similar coagulation profiles, plasma lactate levels, and postinjury blood loss compared with those treated with FFP. Swine treated with 1:1 FFP-PRBCs were similar to those treated with 1:1 LP-PRBCs. Resuscitation with LP resulted in a reduction in postresuscitation interleukin 6 expression compared with resuscitation with FFP. Conclusions: The process of lyophilization and reconstitution of plasma reduces coagulation factor activity by 14%, without acute differences in blood loss. Lyophilized plasma can be used for resuscitation in a severe multiple trauma and hemorrhagic shock swine model with efficacy equal to that of FFP and with decreased interleukin 6 production.

    Original languageEnglish (US)
    Pages (from-to)829-834
    Number of pages6
    JournalArchives of Surgery
    Volume144
    Issue number9
    DOIs
    StatePublished - Sep 2009

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    Resuscitation
    Swine
    Wounds and Injuries
    Blood Coagulation Factors
    Freeze Drying
    Erythrocytes
    Multiple Trauma
    Interleukin-6
    Hemorrhagic Shock
    Trauma Centers
    Laboratory Animals
    Blood Coagulation
    Acidosis
    Hypothermia

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Spoerke, N., Zink, K., Cho, S. D., Differding, J., Muller, P., Karahan, A., ... Schreiber, M. (2009). Lyophilized plasma for resuscitation in a swine model of severe injury. Archives of Surgery, 144(9), 829-834. https://doi.org/10.1001/archsurg.2009.154

    Lyophilized plasma for resuscitation in a swine model of severe injury. / Spoerke, Nicholas; Zink, Karen; Cho, S. David; Differding, Jerome; Muller, Patrick; Karahan, Ayhan; Sondeen, Jill; Holcomb, John B.; Schreiber, Martin.

    In: Archives of Surgery, Vol. 144, No. 9, 09.2009, p. 829-834.

    Research output: Contribution to journalArticle

    Spoerke, N, Zink, K, Cho, SD, Differding, J, Muller, P, Karahan, A, Sondeen, J, Holcomb, JB & Schreiber, M 2009, 'Lyophilized plasma for resuscitation in a swine model of severe injury', Archives of Surgery, vol. 144, no. 9, pp. 829-834. https://doi.org/10.1001/archsurg.2009.154
    Spoerke N, Zink K, Cho SD, Differding J, Muller P, Karahan A et al. Lyophilized plasma for resuscitation in a swine model of severe injury. Archives of Surgery. 2009 Sep;144(9):829-834. https://doi.org/10.1001/archsurg.2009.154
    Spoerke, Nicholas ; Zink, Karen ; Cho, S. David ; Differding, Jerome ; Muller, Patrick ; Karahan, Ayhan ; Sondeen, Jill ; Holcomb, John B. ; Schreiber, Martin. / Lyophilized plasma for resuscitation in a swine model of severe injury. In: Archives of Surgery. 2009 ; Vol. 144, No. 9. pp. 829-834.
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    abstract = "Hypothesis: Lyophilized plasma (LP) is as safe and effective as fresh frozen plasma (FFP) for resuscitation after severe trauma. Design: Multicenter animal study. Setting: Animal laboratories, 2 level I trauma centers. Participants: Thirty-two Yorkshire crossbred swine. Interventions: Lyophilized plasma was analyzed for factor levels and clotting activity before lyophilization and after reconstitution. Swine were subjected to complex multiple trauma including extremity fracture, hemorrhage, severe liver injury, acidosis, and hypothermia. They were then resuscitated with FFP, LP, FFP and packed red blood cells (PRBCs) in a ratio of 1:1, or 1:1 LP and PRBCs. Main Outcome Measures: Residual clotting activity of LP after reconstitution, swine mortality, hemodynamic measures, total blood loss, coagulation profiles, and inflammatory measures. Results: Lyophilization decreased clotting factor activity by an average of 14{\%}. Survival and heart rate were similar between all groups. Swine resuscitated with LP had equivalent or higher mean arterial pressures. Swine treated with LP had similar coagulation profiles, plasma lactate levels, and postinjury blood loss compared with those treated with FFP. Swine treated with 1:1 FFP-PRBCs were similar to those treated with 1:1 LP-PRBCs. Resuscitation with LP resulted in a reduction in postresuscitation interleukin 6 expression compared with resuscitation with FFP. Conclusions: The process of lyophilization and reconstitution of plasma reduces coagulation factor activity by 14{\%}, without acute differences in blood loss. Lyophilized plasma can be used for resuscitation in a severe multiple trauma and hemorrhagic shock swine model with efficacy equal to that of FFP and with decreased interleukin 6 production.",
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    AU - Spoerke, Nicholas

    AU - Zink, Karen

    AU - Cho, S. David

    AU - Differding, Jerome

    AU - Muller, Patrick

    AU - Karahan, Ayhan

    AU - Sondeen, Jill

    AU - Holcomb, John B.

    AU - Schreiber, Martin

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    N2 - Hypothesis: Lyophilized plasma (LP) is as safe and effective as fresh frozen plasma (FFP) for resuscitation after severe trauma. Design: Multicenter animal study. Setting: Animal laboratories, 2 level I trauma centers. Participants: Thirty-two Yorkshire crossbred swine. Interventions: Lyophilized plasma was analyzed for factor levels and clotting activity before lyophilization and after reconstitution. Swine were subjected to complex multiple trauma including extremity fracture, hemorrhage, severe liver injury, acidosis, and hypothermia. They were then resuscitated with FFP, LP, FFP and packed red blood cells (PRBCs) in a ratio of 1:1, or 1:1 LP and PRBCs. Main Outcome Measures: Residual clotting activity of LP after reconstitution, swine mortality, hemodynamic measures, total blood loss, coagulation profiles, and inflammatory measures. Results: Lyophilization decreased clotting factor activity by an average of 14%. Survival and heart rate were similar between all groups. Swine resuscitated with LP had equivalent or higher mean arterial pressures. Swine treated with LP had similar coagulation profiles, plasma lactate levels, and postinjury blood loss compared with those treated with FFP. Swine treated with 1:1 FFP-PRBCs were similar to those treated with 1:1 LP-PRBCs. Resuscitation with LP resulted in a reduction in postresuscitation interleukin 6 expression compared with resuscitation with FFP. Conclusions: The process of lyophilization and reconstitution of plasma reduces coagulation factor activity by 14%, without acute differences in blood loss. Lyophilized plasma can be used for resuscitation in a severe multiple trauma and hemorrhagic shock swine model with efficacy equal to that of FFP and with decreased interleukin 6 production.

    AB - Hypothesis: Lyophilized plasma (LP) is as safe and effective as fresh frozen plasma (FFP) for resuscitation after severe trauma. Design: Multicenter animal study. Setting: Animal laboratories, 2 level I trauma centers. Participants: Thirty-two Yorkshire crossbred swine. Interventions: Lyophilized plasma was analyzed for factor levels and clotting activity before lyophilization and after reconstitution. Swine were subjected to complex multiple trauma including extremity fracture, hemorrhage, severe liver injury, acidosis, and hypothermia. They were then resuscitated with FFP, LP, FFP and packed red blood cells (PRBCs) in a ratio of 1:1, or 1:1 LP and PRBCs. Main Outcome Measures: Residual clotting activity of LP after reconstitution, swine mortality, hemodynamic measures, total blood loss, coagulation profiles, and inflammatory measures. Results: Lyophilization decreased clotting factor activity by an average of 14%. Survival and heart rate were similar between all groups. Swine resuscitated with LP had equivalent or higher mean arterial pressures. Swine treated with LP had similar coagulation profiles, plasma lactate levels, and postinjury blood loss compared with those treated with FFP. Swine treated with 1:1 FFP-PRBCs were similar to those treated with 1:1 LP-PRBCs. Resuscitation with LP resulted in a reduction in postresuscitation interleukin 6 expression compared with resuscitation with FFP. Conclusions: The process of lyophilization and reconstitution of plasma reduces coagulation factor activity by 14%, without acute differences in blood loss. Lyophilized plasma can be used for resuscitation in a severe multiple trauma and hemorrhagic shock swine model with efficacy equal to that of FFP and with decreased interleukin 6 production.

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