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Interventional Vitamin C A Strategy for Attenuation of Coagulopathy and Inflammation in Hemorrhagic Trauma and Shock

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Technical Report,30 Sep 2015,29 Sep 2016

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Virginia Commonwealth University Richmond United States

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This is a novel study of high dose parenteral vitamin C VitC in a swine model of combined hemorrhagic shock and tissue trauma that simulates the course of a combat casualty by exhibiting the components of the lethal triad of acidosis, coagulopathy and hypothermia. The major goal of Year1 of this project was to determine the effective parenteral dose of VitC. We successfully developed a reproducible traumatic injuryshock hemorrhage model in swine. This model produced significant platelet dysfunction and a reduction in global coagulation. Histological staining H and E of lung showed extensive hemorrhage, septal edema, protein leak and exuberant infiltration of inflammatory cells. Significant hemorrhage and cellular damage were also evident in liver and kidney sections. Treatment with VitC 200mgkg was associated with a lower degree of histological tissue injury and a significantly reduced ALI score. Treatment with VitC also reduced the expression of pro-inflammatory mediators in lungs, liver and kidneys. In addition, VitC attenuated the mRNA expression of plasminogen activated inhibitor-1 and tissue factor, and increased mRNA expression of thrombomodulin. Our data suggest that intravenous VitC at200mgkg appears to significantly ameliorate the inflammatory status and trauma induced coagulopathy in this model.

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