Optimization of Lyophilized Plasma for Use in Combat Casualties
Annual rept. 29 Dec 2010-28 Dec 2011
OREGON HEALTH AND SCIENCE UNIV PORTLAND
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Hypothesis It is our hypothesis that by minimizing the volume of the reconstitution fluid and optimizing its constituents, we can create lyophilized plasma that is superior to the currently available product. We also hypothesize that this new lyophilized plasma will be superior to FFP with respect to hemodynamic changes, coagulopathy, blood loss, and inflammatory changes in our established polytrauma model in swine. Specific Aims Two specific aims will be proposed to evaluate the efficacy and safety of optimized lyophilized plasma. Specific Aim 1 will establish the minimum amount of fluid necessary to successfully reconstitute lyophilized plasma without reducing its efficacy. Specific Aim 2 will determine the optimal fluid in which to reconstitute lyophilized plasma while maximizing the physiologic effects. Study Design The specific aims will be evaluated using a severe multiple injury trauma model in swine. Animals will undergo a standardized femur fracture, followed by controlled hemorrhage, dilutional resuscitation, and induction of hypothermia, reproducing the lethal triad. After stabilization, animals will undergo a grade V liver injury. The optimal volume and constitution of the reconstitution fluid for the lyophilized plasma will be determined. Endpoints will include physiology, mortality, correction of coagulopathy, and inflammatory markers. Relevance Lyophilized plasma is a light weight powder that remains stable for a prolonged period of time and in a broad range of temperatures. The powder is rapidly reconstituted into a product that preserves coagulation factor activity and suppresses harmful inflammation. By being available on the battlefield and all echelons of casualty care, optimized lyophilized plasma could save countless lives.
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