Acute coagulopathy in a porcine venous hemorrhage and ischemia reperfusion model.
Am J Surg
; 207(5): 637-41; discussion 641, 2014 May.
Article
in En
| MEDLINE
| ID: mdl-24791624
ABSTRACT
BACKGROUND:
Injury-related coagulopathy is a complex process. We analyzed coagulation in a swine model of shock using rotational thromboelastometry (ROTEM).METHODS:
Forty-eight swine underwent laparotomy, 35% hemorrhage, supraceliac aortic cross-clamp, then reperfusion and resuscitation. ROTEM measurements and standard labs were taken at baseline and 6 hours into resuscitation.RESULTS:
Clot formation time (98 vs 53 seconds, P = .001) and international normalized ratio (1.67 vs 1.01, P < .001) were prolonged after resuscitation. Maximum clot firmness (61 vs 72 mm, P < .001) and fibrinogen levels (94 vs 165, P < .001) declined significantly during resuscitation. Despite decreased fibrinogen levels, there was no significant increase in fibrinolysis as measured by maximum lysis (3.9% vs 3.8%, P = .99).CONCLUSIONS:
ROTEM demonstrated the development of an acute coagulopathy. The most significant impacts on coagulopathy were seen with clot initiation and fibrin polymerization. Clot strength decreased over time, although there was little impact on clot breakdown because of fibrinolysis.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Hemorrhagic
/
Blood Coagulation Disorders
/
Reperfusion Injury
Type of study:
Observational_studies
Limits:
Animals
Language:
En
Journal:
Am J Surg
Year:
2014
Document type:
Article
Affiliation country:
United States