Clotting Factor XIII and desmopressin improve hemostasis in uncontrolled bleeding
Acta cir. bras
;
30(3): 170-177, 03/2015. graf
Article
in English
| LILACS
| ID: lil-741040
ABSTRACT
PURPOSE:
To investigate hemostatic effects of supplementary factor XIII and desmopressin (DDAVP) in resuscitation of uncontrolled bleeding.METHODS:
Fifty-four rabbits were randomized in nine groups G1 Sham; G2 FXIII and normotensive resuscitation (NBP); G3 FXIII and permissive hypotension (PH) (MAP 60% baseline); G4 FXIII/DDAVP/NBP; G5 FXIII/DDAVP/PH; G6 NBP only; G7 FXIII no hemorrhage; G8 FXIII/DDAVP no hemorrhage; G9 PH only. Thromboelastometry and intra-abdominal blood loss were assessed. Scanning electron microscopy (EM) of the clots was performed.RESULTS:
Compared to Sham, only G8 (FXIII/DDAVP w/o hemorrhage) showed clotting time (CT) significantly lower (p<0.05). NBP alone (G6) resulted in significantly prolonged CT compared to G2, G3 and G5 (p<0.05). Similarly, median alpha angle was significantly larger in G3,4,5, and 9 compared to G6 (p<0.05). Area under the curve was significantly greater in G5 than G2. Intra-abdominal blood loss was lower in G5 and G9 compared to G2 and G6. FXIII/DDAVP and PH resulted in more robust fibrin mesh by EM.CONCLUSIONS:
Normotensive resuscitation provokes more bleeding and worsens coagulation compared to pH, that is partially reversed by factor XIII and desmopressin. FXIII and DDAVP can synergistically improve coagulation. Permissive hypotension reduces bleeding regardless of those agents. .
Full text:
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Index:
LILACS (Americas)
Main subject:
Radiology
/
Career Choice
/
Academic Medical Centers
/
Faculty, Medical
/
Internship and Residency
Type of study:
Controlled clinical trial
/
Prognostic study
Country/Region as subject:
North America
Language:
English
Journal:
Acta cir. bras
Journal subject:
General Surgery
/
Procedimentos Cir£rgicos Operat¢rios
Year:
2015
Type:
Article
/
Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of Minas Gerais/BR
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