Abstract：
BACKGROUND: Hemorrhagic shock is well documented as a leading cause of preventable fatalities among military casualties. During military operations plasma can be transfused while waiting for whole blood. This study was conducted to assess the safety and efficacy of two new freeze-dried plasma formulations in a porcine model of traumatic hemorrhagic shock.
METHODS: In the face of species-specific transfusion, transfusible blood products were derived from porcine sources. The efficacy of three lyophilized plasma (LP) formulations was evaluated: lyophilized plasma (LP), concentrated lyophilized plasma (CLP), and platelet-rich concentrated lyophilized plasma (PCLP). Pigs were subjected to multi-trauma and hemorrhagic shock. Ninety minutes post-shock induction, the animals were treated with one of the three lyophilized products. Monitoring included systolic blood pressure and cardiac output. Point-of-care and laboratory diagnostic tests were used to assess renal function, real-time hemostasis (ROTEM), and coagulation. Histological examinations of kidney, lung, and muscle tissues were conducted 4 h after shock induction.
RESULTS: CLP and PCLP significantly improved systolic blood pressure and cardiac output and positively influenced base excess, creatinine, various ROTEM, and coagulation markers compared with standard LP without histologic modification. No adverse effect was associated with the transfusion of any of the plasma products throughout the experimental procedures.
CONCLUSIONS: Both CLP and PCLP exhibit promising therapeutic potential for managing hemorrhagic shock in scenario where whole blood supplies are limited. However, the distinct physiological and coagulation characteristics of the swine model necessitate further investigation using humanized preclinical models to fully understand their clinical applicability and constraints.
METHODS: In the face of species-specific transfusion, transfusible blood products were derived from porcine sources. The efficacy of three lyophilized plasma (LP) formulations was evaluated: lyophilized plasma (LP), concentrated lyophilized plasma (CLP), and platelet-rich concentrated lyophilized plasma (PCLP). Pigs were subjected to multi-trauma and hemorrhagic shock. Ninety minutes post-shock induction, the animals were treated with one of the three lyophilized products. Monitoring included systolic blood pressure and cardiac output. Point-of-care and laboratory diagnostic tests were used to assess renal function, real-time hemostasis (ROTEM), and coagulation. Histological examinations of kidney, lung, and muscle tissues were conducted 4 h after shock induction.
RESULTS: CLP and PCLP significantly improved systolic blood pressure and cardiac output and positively influenced base excess, creatinine, various ROTEM, and coagulation markers compared with standard LP without histologic modification. No adverse effect was associated with the transfusion of any of the plasma products throughout the experimental procedures.
CONCLUSIONS: Both CLP and PCLP exhibit promising therapeutic potential for managing hemorrhagic shock in scenario where whole blood supplies are limited. However, the distinct physiological and coagulation characteristics of the swine model necessitate further investigation using humanized preclinical models to fully understand their clinical applicability and constraints.
摘要：
背景：失血性休克是军事伤亡中可预防死亡的主要原因。在军事行动期间，可以在等待全血的同时输入血浆。本研究旨在评估两种新型冻干血浆制剂在猪创伤失血性休克模型中的安全性和有效性。
方法：面对物种特异性输血，可输血的血液制品来自猪源。评估了三种冻干血浆（LP）制剂的功效：冻干血浆（LP），浓缩冻干血浆（CLP），和富含血小板的浓缩冻干血浆(PCLP)。猪遭受多重创伤和出血性休克。休克诱导后90分钟，用三种冻干产品中的一种治疗动物。监测包括收缩压和心输出量。现场护理和实验室诊断测试用于评估肾功能，实时止血(ROTEM),和凝结。肾脏的组织学检查，肺，和肌肉组织在休克诱导后4小时进行。
结果：CLP和PCLP显著改善收缩压和心输出量，并积极影响基础过量，肌酐,各种ROTEM，和凝血标志物与未进行组织学修饰的标准LP进行比较。在整个实验过程中，任何血浆产品的输注都没有不良反应。
结论：在全血供应有限的情况下，CLP和PCLP在管理出血性休克方面均表现出良好的治疗潜力。然而,猪模型的独特生理和凝血特征需要使用人源化临床前模型进行进一步研究，以充分了解其临床适用性和局限性。
方法：面对物种特异性输血，可输血的血液制品来自猪源。评估了三种冻干血浆（LP）制剂的功效：冻干血浆（LP），浓缩冻干血浆（CLP），和富含血小板的浓缩冻干血浆(PCLP)。猪遭受多重创伤和出血性休克。休克诱导后90分钟，用三种冻干产品中的一种治疗动物。监测包括收缩压和心输出量。现场护理和实验室诊断测试用于评估肾功能，实时止血(ROTEM),和凝结。肾脏的组织学检查，肺，和肌肉组织在休克诱导后4小时进行。
结果：CLP和PCLP显著改善收缩压和心输出量，并积极影响基础过量，肌酐,各种ROTEM，和凝血标志物与未进行组织学修饰的标准LP进行比较。在整个实验过程中，任何血浆产品的输注都没有不良反应。
结论：在全血供应有限的情况下，CLP和PCLP在管理出血性休克方面均表现出良好的治疗潜力。然而,猪模型的独特生理和凝血特征需要使用人源化临床前模型进行进一步研究，以充分了解其临床适用性和局限性。
