BackgroundHemorrhagic 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.Study Design and MethodsIn 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.ResultsCLP 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.ConclusionBoth 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.

中文翻译：

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新型冻干血浆产品在猪战斗伤亡模型中的功效和安全性


背景 失血性休克被充分证明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性失血性休克模型中的安全性和有效性。研究设计和方法面对物种特异性输血，可输血制品来自猪源。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）。猪遭受多重创伤和失血性休克。电击诱导九十分钟后，用三种冻干产品中的一种对动物进行治疗。监测包括收缩压和心输出量。使用现场护理和实验室诊断测试来评估肾功能、实时止血 (ROTEM) 和凝血功能。电击诱导 4 小时后对肾、肺和肌肉组织进行组织学检查。结果与未经组织学修饰的标准 LP 相比，CLP 和 PCLP 显着改善收缩压和心输出量，并对碱过剩、肌酐、各种 ROTEM 和凝血标记物产生积极影响。在整个实验过程中，没有与输注任何血浆产品相关的不良反应。 结论 CLP 和 PCLP 在全血供应有限的情况下，在控制失血性休克方面表现出良好的治疗潜力。 然而，猪模型独特的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限制。