Coagulation patterns following haemoglobin-based oxygen carrier resuscitation in severe uncontrolled haemorrhagic shock in swine

summary Massive blood loss due to penetrating trauma and internal organ damage can cause severe haemorrhagic shock (HS), leading to a severely compromised haemostatic balance. This study evaluated the effect of bovine polymerized haemoglobin (Hb) (Hb‐based oxygen carrier, HBOC) resuscitation on haem...

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Published in:Transfusion medicine (Oxford, England) England), 2006-08, Vol.16 (4), p.290-302
Main Authors: Arnaud, F., Handrigan, M., Hammett, M., Philbin, N., Rice, J., Dong, F., Pearce, L. B., McCarron, R., Freilich, D.
Format: Article
Language:English
Subjects:
Abdominal Injuries - complications
Abdominal Injuries - therapy
Animals
Biomarkers - blood
Blood Coagulation
Blood Coagulation Tests
Blood Substitutes - administration & dosage
Blood Transfusion
haemostasis
Hemoglobins - administration & dosage
Hemostasis
Liver - injuries
oxygen carriers
Platelet Function Tests
resuscitation
Resuscitation - methods
Shock, Hemorrhagic - blood
Shock, Hemorrhagic - therapy
Swine
swine model
Time Factors
transfusion
trauma
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Summary:summary Massive blood loss due to penetrating trauma and internal organ damage can cause severe haemorrhagic shock (HS), leading to a severely compromised haemostatic balance. This study evaluated the effect of bovine polymerized haemoglobin (Hb) (Hb‐based oxygen carrier, HBOC) resuscitation on haemostasis in a swine model of uncontrolled HS. Following liver injury/HS, swine received HBOC (n= 8), Hextend (HEX) (n= 8) or no resuscitation (NON) (n= 8). Fluids were infused to increase mean arterial pressure above 60 mmHg and to reduce heart rate to baseline. At 4 h, the animals were eligible for blood transfusions. Prothrombin time (PT), activated partial thromboplastin time, fibrinogen, thromboelastography (TEG) and platelet function analyser closure time (PFA‐CT) were compared by using mixed statistical model. At 4 h, blood loss (% estimated blood volume) was comparable for HBOC (65·5 ± 18·5%) and HEX (80·8 ± 14·4%) and less for NON (58·7 ± 10·1%; P < 0·05). Resuscitation‐induced dilutional coagulopathy was observed with HBOC and HEX, as indicated by reduced haematocrit, platelets and fibrinogen (P 
ISSN:0958-7578
1365-3148
DOI:10.1111/j.1365-3148.2006.00678.x