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DTIC ADA612363: Optimization of Lyophilized Plasma for Use in Combat Casualties

Purpose: Hemostatic resuscitation is superior to crystalloid resuscitation in restoring blood volume, correcting coagulopathy, minimizing dysfunctional inflammation, and acidosis. Resuscitation with full volume lyophilized plasma (LP) reduces blood loss, corrects coagulopathy, and decreases inflammation in a swine polytrauma and hemorrhagic shock model. This study compared the efficacy of full volume LP to low volume hypertonic LP. Scope: Prior to in vivo testing, in vivo analysis of the plasma was analyzed for electrolyte content, osmolarity and coagulation factor activity. Twenty swine were anesthetized and subjected to a validated model of polytrauma and hemorrhagic shock. They were randomized with lyophilized plasma (LP) reconstituted to either 100% (100%LP) or half (50%LP) the original plasma volume. Physiologic data were monitored. Blood loss and hematocrit levels were measured. Coagulation status was evaluated utilizing thrombelastography (TEG). Serum and tissue were collected to assess inflammatory markers. Major Findings: 50%LP had higher electrolyte concentrations, osmolarity, and increased coagulation factor activity levels by volume compared to 100%LP. Blood loss, hemat

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