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lyophilized plasma hemorrhage

Ihab Halaweish, Ted Bambakidis, Vahagn C Nikolian, Patrick Georgoff, Peter Bruhn, Patryk Piascik, Lisa Buckley, Ashok Srinivasan, Baoling Liu, Yongqing Li, Hasan B Alam
BACKGROUND: Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) is highly lethal. In previous models of combined TBI + HS, we showed that early resuscitation with fresh frozen plasma (FFP) improves neurologic outcomes. Delivering FFP, however, in austere environments is difficult. Lyophilized plasma (LP) is a logistically superior alternative to FFP, but data are limited regarding its efficacy for treatment of TBI. We conducted this study to determine the safety and long-term outcomes of early treatment with LP in a large animal model of TBI + HS...
December 2016: Journal of Trauma and Acute Care Surgery
Zhanglong Peng, Shibani Pati, Magali J Fontaine, Kelly Hall, Anthony V Herrera, Rosemary A Kozar
BACKGROUND: Clinical studies have demonstrated that the early and empiric use of plasma improves survival after hemorrhagic shock. We have demonstrated in rodent models of hemorrhagic shock that resuscitation with plasma is protective to the lungs compared with lactated Ringer's solution. As our long-term objective is to determine the molecular mechanisms that modulate plasma's protective effects in injured bleeding patients, we have used human plasma in a mouse model of hemorrhagic shock...
November 2016: Journal of Trauma and Acute Care Surgery
Zhanglong Peng, Shibani Pati, Magaili J Fontaine, Kelly Hall, Anthony V Herrera, Rosemary Ann Kozar
BACKGROUND: Clinical studies have demonstrated that the early and empiric use of plasma improves survival after hemorrhagic shock. We have demonstrated in rodent models of hemorrhagic shock that resuscitation with plasma is protective to the lungs compared to lactated Ringers. As our long term objective is to determine the molecular mechanisms that modulate plasma's protective effects in injured bleeding patients, we have used human plasma in a mouse model of hemorrhagic shock. The goal of the current experiments is to determine if there are significant adverse effects on lung injury when using human versus mouse plasma in an established murine model of hemorrhagic shock and laparotomy...
August 16, 2016: Journal of Trauma and Acute Care Surgery
Justin J J Watson, Shibani Pati, Martin A Schreiber
Traumatic hemorrhage is the leading cause of preventable death after trauma. Early transfusion of plasma and balanced transfusion have been shown to optimize survival, mitigate the acute coagulopathy of trauma, and restore the endothelial glycocalyx. There are a myriad of plasma formulations available worldwide, including fresh frozen plasma, thawed plasma, liquid plasma, plasma frozen within 24 h, and lyophilized plasma (LP). Significant equipoise exists in the literature regarding the optimal plasma formulation...
November 2016: Shock
Anthony E Pusateri, Michael B Given, Martin A Schreiber, Philip C Spinella, Shibani Pati, Rosemary A Kozar, Abdul Khan, Joseph A Dacorta, Kevin R Kupferer, Nicolas Prat, Heather F Pidcoke, Victor W Macdonald, Wilbur W Malloy, Anne Sailliol, Andrew P Cap
The early transfusion of plasma is important to ensure optimal survival of patients with traumatic hemorrhage. In military and remote or austere civilian settings, it may be impossible to move patients to hospital facilities within the first few hours of injury. A dried plasma product with reduced logistical requirements is needed to enable plasma transfusion where medically needed, instead of only where freezers and other equipment are available. First developed in the 1930s, pooled lyophilized plasma was widely used by British and American forces in WWII and the Korean War...
April 2016: Transfusion
Antoni R Macko, Randy F Crossland, Andrew P Cap, Darren M Fryer, Thomas A Mitchell, Anthony E Pusateri, Forest R Sheppard
BACKGROUND: Hemorrhage remains the leading cause of potentially survivable trauma mortality. Recent reports indicate that injuries sustained in noncompressible anatomic locations (i.e., truncal and junctional) account for 86.5% of hemorrhage-related deaths. Infusible human platelet-derived hemostatic agents (hPDHAs) represent a promising strategy to reduce blood loss from noncompressible injuries. Here, we evaluate the hemostatic efficacy of a lyophilized hPDHA in a rhesus macaque model of severe, uncontrolled hemorrhage...
April 2016: Journal of Trauma and Acute Care Surgery
Sean P McCully, David T Martin, Mackenzie R Cook, Nicole T Gordon, Belinda H McCully, Tim H Lee, Rondi K Dean, Elizabeth A Rick, Alexis M Moren, Kelly A Fair, Vicente J Undurraga, Kathrine M Watson, Nathan W Anderson, Martin A Schreiber
BACKGROUND: Compared with lyophilized plasma (LP) buffered with other acids, LP with ascorbic acid (AA) attenuates systemic inflammation and DNA damage in a combat relevant polytrauma swine model. We hypothesize that increasing concentrations of AA in transfused LP will be safe, will be hemodynamically well tolerated, and will attenuate systemic inflammation following polytraumatic injury and hemorrhage in swine. METHODS: This prospective, randomized, blinded study involved 52 female swine...
July 2015: Journal of Trauma and Acute Care Surgery
Sean P McCully, Tim H Lee, Belinda H McCully, Claire L Sands, Elizabeth A Rick, Rondi K Dean, Nathan W Anderson, David A Hampton, Scott G Louis, Jerome A Differding, Martin A Schreiber
BACKGROUND: Dysfunctional inflammation following traumatic hemorrhage can lead to multiple-organ failure and death. In our polytrauma swine model, lyophilized plasma (LP) reconstituted with sterile water and ascorbic acid suppressed systemic inflammation and attenuated DNA damage. However, it remains unknown whether the inflammatory response is affected by the type of fluid used to reconstitute LP. We hypothesized that common resuscitation fluids such as normal saline (LP-NS), lactated Ringer's solution (LP-LR), Hextend (LP-HX), or sterile water (LP-SW) would yield similar inflammation profiles and DNA damage following LP reconstitution and transfusion...
February 2015: Journal of Trauma and Acute Care Surgery
Betzabeth Pereira, Josmary Brazón
ETHNOPHARMACOLOGICAL RELEVANCE: Brownea grandiceps flowers are used in Venezuelan folk medicine as anti-hemorrhagic in women with heavy menstrual blood loss (menorrhagia). However, prior to this study, there were no scientific investigations to support this fact, because the aqueous extract from Brownea grandiceps flowers had not been previously evaluated neither phytochemically nor biologically. The objective of this work was to evaluate in vitro the effects of aqueous extract from Brownea grandiceps flowers on the coagulation system and fibrinolysis...
February 3, 2015: Journal of Ethnopharmacology
Yuzhu Bian, Thomas Ming Swi Chang
We crosslink hemoglobin (Hb), superoxide dismutase (SOD), catalase (CAT), and carbonic anhydrase (CA) to form a soluble polyHb-SOD-CAT-CA nanobiotechnological complex. The obtained product is a soluble complex with three enhanced red blood cell (RBC) functions and without blood group antigens. In the present study, 2/3 of blood volume was removed to result in 90-min hemorrhagic shock at mean arterial blood pressure (MAP) of 30 mmHg. This was followed by the reinfusion of different resuscitation fluids, then followed for another 60 min...
February 2015: Artificial Cells, Nanomedicine, and Biotechnology
Xiao Yang, Xiaoqing Miao, Fangrui Cao, Shang Li, Nana Ai, Qi Chang, Simon M Y Lee, Ying Zheng
This work addressed solubility and membrane permeability problems of Biopharmaceutics Classification System (BCS) Class IV glycoside scutellarin (SG) by developing a nanosuspension of its aglycone scutellarein (S) as a precursor. An S nanosuspension containing poloxamer 188 was prepared using antisolvent precipitation where hydroxypropyl-β-cyclodextrin was utilized as a lyophilizing protectant. Particle size and polydispersity index after redispersion were 342.6 ± 18.2 and 0.32 ± 0.06 nm, respectively. The dissolution rate of the S nanosuspension was superior compared with the physical mixture...
November 2014: Journal of Pharmaceutical Sciences
Camille Escadafal, Oumar Faye, Amadou Alpha Sall, Ousmane Faye, Manfred Weidmann, Oliver Strohmeier, Felix von Stetten, Josef Drexler, Michael Eberhard, Matthias Niedrig, Pranav Patel
BACKGROUND: Yellow fever (YF) is an acute viral hemorrhagic disease transmitted by Aedes mosquitoes. The causative agent, the yellow fever virus (YFV), is found in tropical and subtropical areas of South America and Africa. Although a vaccine is available since the 1930s, YF still causes thousands of deaths and several outbreaks have recently occurred in Africa. Therefore, rapid and reliable diagnostic methods easy to perform in low-resources settings could have a major impact on early detection of outbreaks and implementation of appropriate response strategies such as vaccination and/or vector control...
March 2014: PLoS Neglected Tropical Diseases
Tim H Lee, Sean P McCully, Belinda H McCully, Claire Sands, David A Hampton, Scott G Louis, Beth Rick, Nathan Anderson, Jerome Differding, Martin A Schreiber
BACKGROUND: Low-volume ascorbic acid-buffered reconstituted lyophilized plasma (LP) provides logistic advantages, reduces the risks for large-volume resuscitation, modulates inflammation, and is equally effective for hemostatic resuscitation as full-volume LP. We compared the physiologic effects of resuscitation using LP reconstituted with sterile water (LP-SW), lactated Ringer's solution (LP-LR), normal saline (LP-NS), and Hextend (LP-Hx). METHODS: Plasma was collected from swine, lyophilized, and then reconstituted into four test solutions: LP-SW, LP-LR, LP-NS, or LP-Hx...
February 2014: Journal of Trauma and Acute Care Surgery
Ayesha M Imam, Guang Jin, Martin Sillesen, Michael Duggan, Cecilie H Jepsen, John O Hwabejire, Jennifer Lu, Baoling Liu, Marc A DeMoya, George C Velmahos, Hasan B Alam
BACKGROUND: Combination of traumatic brain injury (TBI) and hemorrhagic shock (HS) can result in significant morbidity and mortality. We have previously shown that early administration of fresh frozen plasma (FFP) in a large animal model of TBI and HS reduces the size of the brain lesion as well as the associated edema. However, FFP is a perishable product that is not well suited for use in the austere prehospital settings. In this study, we tested whether a shelf-stable, low-volume, lyophilized plasma (LSP) product was as effective as FFP...
December 2013: Journal of Trauma and Acute Care Surgery
Tim H Lee, Kate Watson, Loïc Fabricant, Jeffrey Barton, Jerome Differding, Igor Kremenevskiy, Claire Sands, Connor Wiles, Jennifer M Watters, Martin A Schreiber
BACKGROUND: We performed this study to optimize reconstituted lyophilized plasma (LP) into a minimal volume fluid that provides effective hemostatic resuscitation for trauma while minimizing logistical limitations. METHODS: We performed a prospective, blinded animal study. Plasma was lyophilized following whole blood collection from anesthetized swine. The minimal volume needed for reconstitution was determined, and this solution was evaluated for safe infusion into the swine...
September 2013: Journal of Trauma and Acute Care Surgery
Kenichi A Tanaka, Katherine Egan, Fania Szlam, Satoru Ogawa, John D Roback, Gautam Sreeram, Robert A Guyton, Edward P Chen
BACKGROUND: Platelet (PLT) and plasma transfusion remain the mainstay hemostatic therapy for perioperative bleeding. Several studies have indicated that acquired fibrinogen (FIB) deficiency can be the primary cause of bleeding after cardiac surgery. The aim of this study was to compare hematologic and transfusion profiles between the first-line FIB replacement and PLT transfusion in post-cardiac surgical bleeding. STUDY DESIGN AND METHODS: In this prospective, randomized, open-label study, 20 adult patients who underwent valve replacement or repair and fulfilled preset visual bleeding scale were randomized to 4 g of FIB or 1 unit of apheresis PLTs...
January 2014: Transfusion
Jürgen Bux, Dieter Dickhörner, Edgar Scheel
BACKGROUND: Transfusion of plasma is a basic treatment for complex coagulopathies as well as in major blood loss. Early transfusion of plasma after trauma with major hemorrhage has been recommended by retrospective studies. However, the use of plasma is often hampered by the need to maintain a cold chain and the time needed for thawing fresh-frozen plasma (FFP). With freeze-dried (lyophilized) plasma (FDP) both difficulties can be avoided. Here, we describe the production, quality characteristics, and our experiences with FDP...
December 2013: Transfusion
Tim H Lee, Philbert Y Van, Nicholas J Spoerke, Gregory J Hamilton, S David Cho, Kate Watson, Jerome Differding, Martin A Schreiber
BACKGROUND: Shock and severe tissue injury lead to an endogenous coagulopathy mediated by activation of Protein C and hyperfibrinolysis known as acute traumatic coagulopathy. Together, hemodilution, acidosis, inflammation, and hypothermia result in a global trauma-induced coagulopathy. Coagulopathy in trauma is associated with mortality. Early and effective hemostatic resuscitation is critical in restoring perfusion, correcting coagulopathy, and saving lives in exsanguinating trauma. Lyophilized plasma (LP) provides a logistically superior alternative to fresh frozen plasma (FFP)...
January 2013: Transfusion
Anne Sailliol, Christophe Martinaud, Andrew P Cap, Corinne Civadier, Benoit Clavier, Anne-Virginie Deshayes, Anne-Christine Mendes, Thomas Pouget, Nicolas Demazeau, Marine Chueca, François-Régis Martelet, Sylvain Ausset
Freeze-dried plasma was developed by the US Army for the resuscitation of combat casualties during World War II. The French Military Blood Institute began producing French lyophilized plasma (FLYP) in 1949, in accordance with French blood product guidelines. Since 2010, a photochemical pathogen inactivation process has been implemented to reduce the remaining transfusion-related infectious risk. All quality controls for this procedure verify that the hemostatic properties of FLYP are conserved. FLYP is compatible with all blood types, can be stored at room temperature for 2 years, and its reconstitution requires less than 6 minutes...
January 2013: Transfusion
Hataichanok Pandith, Suchitra Thongpraditchote, Yuvadee Wongkrajang, Wandee Gritsanapan
CONTEXT: Chromolaena odorata (L.) R.M.King & H.Rob. (Asteraceae) or Siam weed has long been used to stop bleeding in Thailand and many countries. Only the aqueous leaf extract was investigated in in vivo and there have been conflicting results of in vitro hemostatic mechanisms of this plant. OBJECTIVE: The most appropriate C. odorata leaf extract that promoted the highest hemostatic activity and the hemostatic mechanisms of these plant extracts will be investigated...
September 2012: Pharmaceutical Biology
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