ArticleThe journal of trauma and acute care surgery2015
Shock-induced systemic hyperfibrinolysis is attenuated by plasma-first resuscitation.
Article in The journal of trauma and acute care surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02736812 (Interest of Pre-hospital Administration of Lyophilized Plasma to Prevent or Treat Coagulopathy Associated With Post-traumatic Hemorrhagic Shock), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Interest of Pre-hospital Administration of Lyophilized Plasma to Prevent or Treat Coagulopathy Associated With Post-traumatic Hemorrhagic Shock (PREHO-PLYO Study )
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- The efficacy and safety of pre-hospital plasma in patients at risk for hemorrhagic shock: an updated systematic review and meta-analysis of randomized controlled trials.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial.Lancet (London, England) · 2018Trial
- Whole blood first resuscitation and association of blood product utilization based on mechanism of injury.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Bridging the gap: whole blood and plasma in prehospital hemorrhagic shock resuscitation.Trauma surgery & acute care open · 2025Review
- Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy.Clinical and experimental emergency medicine · 2024Article
- Severe Trauma-Induced Coagulopathy: Molecular Mechanisms Underlying Critical Illness.International journal of molecular sciences · 2023Review
- How to manage coagulopathies in critically ill patients.Intensive care medicine · 2023Review
- Trauma-induced coagulopathy.Nature reviews. Disease primers · 2021Review
- Early abnormal fibrinolysis and mortality in patients with thermal injury: a prospective cohort study.BJS open · 2021Observational
- Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy.The Journal of surgical research · 2021Article
- 28-day thawed plasma maintains αVox sanguinis · 2021Article
- Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications.Frontiers in veterinary science · 2021Review
- Use of Viscoelastography in Malignancy-Associated Coagulopathy and Thrombosis: A Review.Seminars in thrombosis and hemostasis · 2019Review
- Citrated kaolin thrombelastography (TEG) thresholds for goal-directed therapy in injured patients receiving massive transfusion.The journal of trauma and acute care surgery · 2018Article
- Systemic hyperfibrinolysis after trauma: a pilot study of targeted proteomic analysis of superposed mechanisms in patient plasma.The journal of trauma and acute care surgery · 2018Article
- Tranexamic acid is associated with increased mortality in patients with physiological fibrinolysis.The Journal of surgical research · 2017Article
- 14-Day thawed plasma retains clot enhancing properties and inhibits tPA-induced fibrinolysis.The Journal of surgical research · 2017Article
- Freeze-dried plasma enhances clot formation and inhibits fibrinolysis in the presence of tissue plasminogen activator similar to pooled liquid plasma.Transfusion · 2017Article
- Nonhuman primate model of polytraumatic hemorrhagic shock recapitulates early platelet dysfunction observed following severe injury in humans.The journal of trauma and acute care surgery · 2017Article
- Establishment and evaluation of rat trauma hemorrhagic liver injury model.International journal of clinical and experimental pathology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundWe developed a hemorrhagic shock animal model to replicate an urban prehospital setting where resuscitation fluids are limited to assess the effect of saline versus plasma in coagulopathic patients. An in vitro model of whole blood dilution with saline exacerbated tissue plasminogen activator (tPA)-mediated fibrinolysis, while plasma dilution did not change fibrinolysis. We hypothesize that shock-induced hyperfibrinolysis can be attenuated by resuscitation with plasma while exacerbated by saline.
methodsSprague-Dawley rats were hemorrhaged to a mean arterial pressure of 25 mm Hg and maintained in shock for 30 minutes. Animals were resuscitated with either normal saline (NS) or platelet-free plasma (PFP) with a 10% total blood volume bolus, followed by an additional 5 minutes of resuscitation with NS to increase blood pressure to a mean arterial pressure of 30 mm Hg. Animals were observed for 15 minutes for the assessment of hemodynamic response and survival. Blood samples were analyzed with thrombelastography paired with protein analysis.
resultsThe median percentage of total blood volume shed per group were similar (NS, 52.5% vs. PFP, 55.7; p = 0.065). Survival was 50% in NS compared with 100% in PFP. The change in LY30 and tPA levels from baseline to shock was similar between groups (LY30 PFP, 10; interquartile range [IQR], 4.3-11.2; NS, 4.5; IQR, 4.1-14.2; p = 1.00; tPA PFP, 16.6 ng/mL; IQR, 13.7-27.8; NS, 22.4; IQR, 20.1-25.5; p = 0.240). After resuscitation, the median change in LY30 was greater in the NS group (13.5; IQR, 3.5-19.9) compared with PFP (-4.9%; IQR, -9.22 to 0.25 p = 0.004), but tPA levels did not significantly change (NS, 1.4; IQR, -6.2 to 7.1 vs. PFP, 1.7; IQR, -5.2 to 6.8; p = 0.699).
conclusionSystemic hyperfibrinolysis is driven by hypoperfusion and associated with increased levels of tPA. Plasma is a superior resuscitation fluid to NS in a prehospital model of severe hemorrhagic shock as it attenuates hyperfibrinolysis and improves systemic perfusion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.