Limited resuscitation with fresh or stored whole blood corrects cardiovascular and metabolic function in a rat model of polytrauma and hemorrhage

Jacob Chen, Xiaowu Wu, Jeffrey Keesee, Bin Liu, Daniel N. Darlington, Andrew P. Cap

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Introduction: We have recently shown that human whole blood stored at 4°C maintains hemostatic and platelet function. In this study, we compared restoration of hemodynamic, metabolic and hemostatic function after limited resuscitation with rat fresh whole blood, rat stored whole blood, or Lactated Ringers in traumatized rats. Methods: Rat whole blood was stored for 10 days at 4°C for evaluation of hemostatic function. Polytrauma was performed on isofluraneanesthetized Sprague-Dawley rats (350-450 g) by damage to the intestines, liver, right leg skeletal muscle, and right femur fracture, followed by 40% hemorrhage. At 1 h, rats were resuscitated (20%) with either fresh whole blood (FWB), stored whole blood, 4°C for 7 days (SWB), Lactated Ringers (LR), or nothing. Blood sampleswere taken before and 2 h after trauma and hemorrhage to evaluate metabolic and hemostatic function. Results: Whole blood stored for 10 days showed a significant prolongation in prothrombin time (PT) and activated partial thromboplastin time (aPTT), and fall in fibrinogen concentration, but no change in Maximum Clot Firmness or speed of clot formation. Platelet function was maintained until day 7 in storage, than fell significantly. Polytrauma and hemorrhage in rats led to a fall in arterial pressure, plasma bicarbonate, fibrinogen, and platelet function, and a rise in plasma lactate, PT, aPTT, and creatinine. Resuscitation with either FWBor 7 daySWB, but not LR, returned arterial pressure, plasma lactate and plasma bicarbonate to levels similar to control, but had no effect on the fall in fibrinogen or platelet function, or the rise in PT, aPTT, or creatinine. Conclusion: Hemostatic and platelet function of rat whole blood stored at 4°C is preserved for at least 7 days in vitro. Low volume resuscitation with SWB or FWB, but not LR, restores hemodynamic and metabolic function, but not the coagulopathy after severe trauma and hemorrhage.

Original languageEnglish (US)
Pages (from-to)208-216
Number of pages9
JournalShock
Volume47
Issue number2
DOIs
StatePublished - Jan 1 2017

Keywords

  • APTT
  • Clotting firmness
  • Coagulation
  • Cold storage
  • Fibrinogen
  • Hemorrhage
  • Platelets
  • Polytrauma
  • PT
  • Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Limited resuscitation with fresh or stored whole blood corrects cardiovascular and metabolic function in a rat model of polytrauma and hemorrhage'. Together they form a unique fingerprint.

Cite this