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The Effects on Thrombin Generation Following Resuscitation with Lactated Ringers and Fresh Frozen Plasma
Author(s) -
Pawelczyk Nicholas S,
Huby Maria,
Baer Lisa A,
Salsbury John R,
Matijevic Nena,
Wang Willa,
Cotton Bryan A,
Holcomb John B,
Wade Charles E
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.1126.6
Subject(s) - resuscitation , fresh frozen plasma , medicine , thrombin generation , anesthesia , thromboelastography , shock (circulatory) , coagulation , saline , thrombin , platelet
Following trauma, patients are infused with fluids such as crystalloids or fresh frozen plasma. Observing thrombin generation is key to demonstrating changes in hemostatic potential due to the infusions. Our objective was to explore the effects of resuscitative fluids on coagulation as measured by Calibrated Automated Thrombography (CAT). Male rats underwent laparotomy with gut externalization and hemorrhagic shock to MAP of 35mmHg until decompensation (inability to auto‐resuscitate). Rats were randomized based on fluids received: Lactated Ringers (LR; n=7) and Fresh Frozen Plasma Day 0 (PL‐0; n=8). PL‐0 was obtained by pooling citrated rat plasma from non‐experimental donor rats and PL‐0 coagulation factors were not significantly different from baseline. Prior to resuscitation, there were no significant differences in coagulation factors between LR and PL‐0. Resuscitation with LR resulted in a significant decrease in lagtime but maintenance of high endogenous thrombin potential (ETP) and peak levels. Resuscitation with PL‐0 resulted in a significant increase in lagtime, ETP, and Peak. Following trauma and hemorrhagic shock, resuscitation with LR produced a prothrombotic state while resuscitation with PL‐0 produced a coagulopathic state. Hemostatic potential is important in determining which fluid may be required during trauma management. (UT Health Science Center–Houston CeTIR Dept Grant).