Deleterious effects of plasma-derived cellular debris in a porcine model of hemorrhagic shock.

Autor: Buckley CT; Department of Surgery, University of South Alabama, Mobile, AL, United States., Lee YL; Department of Surgery, University of South Alabama, Mobile, AL, United States., Michele Schuler A; Department of Comparative Medicine, University of South Alabama, United States; Department of Microbiology and Immunology, University of South Alabama, United States., Langley RJ; Department of Cellular & Molecular Pharmacology, University of South Alabama, United States., Kutcher ME; Department of Surgery, University of Mississippi, United States., Barrington R; Department of Microbiology and Immunology, University of South Alabama, United States., Audia JP; Department of Microbiology and Immunology, University of South Alabama, United States., Simmons JD; Department of Surgery, University of South Alabama, Mobile, AL, United States; Department of Cellular & Molecular Pharmacology, University of South Alabama, United States. Electronic address: jdsimmons@health.southalabama.edu.
Jazyk: angličtina
Zdroj: Injury [Injury] 2024 May; Vol. 55 (5), pp. 111300. Date of Electronic Publication: 2023 Dec 23.
DOI: 10.1016/j.injury.2023.111300
Abstrakt: Background: Recent studies identify large quantities of inflammatory cellular debris within Fresh Frozen Plasma (FFP). As FFP is a mainstay of hemorrhagic shock resuscitation, we used a porcine model of hemorrhagic shock and ischemia/reperfusion to investigate the inflammatory potential of plasma-derived cellular debris administered during resuscitation.
Methods: The porcine model of hemorrhagic shock included laparotomy with 35 % hemorrhage (Hem), 45 min of ischemia from supraceliac aortic occlusion with subsequent clamp release (IR), followed by protocolized resuscitation for 6 h. Cellular debris (Debris) was added to the resuscitation phase in three groups. The four groups consisted of Hem + IR (n = 4), Hem + IR + Debris (n = 3), Hem + Debris (n = 3), and IR + Debris (n = 3). A battery of laboratory, physiologic, cytokine, and outcome data were compared between groups.
Results: As expected, the Hem + IR group showed severe time dependent decrements in organ function and physiologic parameters. All animals that included both IR and Debris (Hem + IR + Debris or IR + Debris) died prior to the six-hour end point, while all animals in the Hem + IR and Hem + Debris survived. Cytokines measured at 30-60 min after initiation of resuscitation revealed significant differences in IL-18 and IL-1β between all groups.
Conclusions: Ischemia and reperfusion appear to prime the immune system to the deleterious effects of plasma-derived cellular debris. In the presence of ischemia and reperfusion, this model showed the equivalency of 100 % lethality when resuscitation included quantities of cellular debris at levels routinely administered to trauma patients during transfusion of FFP. A deeper understanding of the immunobiology of FFP-derived cellular debris is critical to optimize resuscitation for hemorrhagic shock.
Competing Interests: Declaration of Competing Interest Nothing to disclose.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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