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Different Recovery Profiles of Coagulation Factors, Thrombin Generation, and Coagulation Function After Hemorrhagic Shock in Pigs
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
BACKGROUND Hemorrhagic shock contributes to coagulopathy after trauma. We investigated daily changes of coagulation components and coagulation function for 5 days in hemorrhaged and resuscitated pigs. METHODS Fourteen pigs were randomized into the sham control C and the hemorrhage and lactated Ringer s resuscitation H-LR groups. On day 1, hemorrhage was induced in the H-LR group by bleeding 35 of the total blood volume, followed by LR resuscitation at three times the bled volume. Pigs in the C group were not hemorrhaged or resuscitated. Hemodynamics and coagulation were measured daily after H-LR on day 1 to day 5. RESULTS No changes in hemodynamics and coagulation function occurred in C. Hemorrhage decreased mean arterial pressure and increased heart rate. LR resuscitation corrected these changes within 2 hours. Compared with the baseline values BL on day 1, fibrinogen levels were decreased to 76 T 6 by H-LR on day 1, increased to 217 T 16 on day 2, and remained increased thereafter platelet counts were decreased to 63 T 5 by H-LR on day 1 and remained lower on days 2 and 3 but returned to BL by days 4 and 5 all p G 0.05. Thrombin generation was decreased by H-LR on days 1 and 2 but then increased to above BL on days 4 and 5. Coagulation factor levels were decreased by H-LR on day 1 but returned to BL on day 3 except for factor XIII. Clot strength was decreased by H-LR on day 1 and returned to BL by day 2. Clot rapidity did not change on day 1 but was decreased on days 2 and 3 and returned to BL on days 4 and 5. CONCLUSION Hemorrhage and resuscitation reduced coagulation components and compromised coagulation function, which showed different recovery profiles over the 5-day study period.
APPROVED FOR PUBLIC RELEASE