Clotting Factor XIII and desmopressin improve hemostasis in uncontrolled bleeding
Acta cir. bras
;
30(3): 170-177, 03/2015. graf
Artigo
em Inglês
| 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. .
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Radiologia
/
Escolha da Profissão
/
Centros Médicos Acadêmicos
/
Docentes de Medicina
/
Internato e Residência
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo prognóstico
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Acta cir. bras
Assunto da revista:
Cirurgia Geral
/
Procedimentos Cir£rgicos Operat¢rios
Ano de publicação:
2015
Tipo de documento:
Artigo
/
Documento de projeto
País de afiliação:
Brasil
Instituição/País de afiliação:
Federal University of Minas Gerais/BR
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