Freeze-Dried Plasma for Major Trauma: Trends and Applications

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 2050

Special Issue Editors


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Guest Editor
Defence Research and Development Canada, Toronto Research Centre, Toronto, M3K 2C9, Canada
Interests: hemostatic agents; thromboelastometry; trauma coagulopathy; bio-mathematical modeling

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Guest Editor
1. Department of Surgery, St. Michael’s Hospital, University of Toronto, Toronto, M5B 1W8, Canada
2. Royal Canadian Medical Services, Ottawa, K1A 0K2, Canada
Interests: massive transfusion; freeze-dried plasma; trauma resuscitation and databases

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Guest Editor
Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, M4N 3M5, Canada
Interests: bleeding and coagulopathic trauma; trauma resuscitation

Special Issue Information

Dear Colleague,

Hemorrhage, frequently complicated by coagulopathy, remains the leading cause of preventable deaths in both civilian and military trauma. There has been an increasing emphasis on hemostatic resuscitation with blood products at the earliest possible time after injury. Given its benefits in reducing blood loss and mortality, and its long storage stability at ambient temperature, high portability, and fast reconstitution for transfusion in an austere field environment, freeze-dried plasma (FDP) is a promising alternative to fresh frozen plasma (FFP) for hemostatic resuscitation in the prehospital settings. Both laboratory and clinical studies have been conducted to show the potential logistic, strategic advantages and therapeutic benefits of FDP as a sufficient blood supply for resuscitation of severely bleeding trauma patients in far-forward military operations and civilian mass-casualty events. The present Special Issue, edited by Drs. Henry Peng, Andrew Beckett and Luis da Luz, disseminate a collection of papers on various topics, including the history, recent advances, and future development of freeze-dried plasma for major trauma.

Dr. Henry Peng
Dr. Andrew Neil Beckett
Dr. Luis da Luz
Guest Editors

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Keywords

  • blood products
  • blood transfusion
  • coagulation
  • freeze-dried plasma
  • fresh frozen plasma
  • hemorrhage
  • hemorrhagic shock
  • hemostatic agent
  • hemostatic resuscitation
  • major trauma
  • massive transfusion
  • prehospital resuscitation
  • trauma coagulopathy

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Published Papers (1 paper)

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Research

14 pages, 1528 KiB  
Article
Post-Reconstitution Hemostatic Stability Profiles of Canadian and German Freeze-Dried Plasma
by Henry T. Peng, Katherine Moes, Kanwal Singh, Shawn G. Rhind, Chantale Pambrun, Craig Jenkins, Luis da Luz and Andrew Beckett
Life 2024, 14(2), 172; https://doi.org/10.3390/life14020172 - 24 Jan 2024
Cited by 2 | Viewed by 1496
Abstract
Despite the importance of the hemostatic properties of reconstituted freeze-dried plasma (FDP) for trauma resuscitation, few studies have been conducted to determine its post-reconstitution hemostatic stability. This study aimed to assess the short- (≤24 h) and long-term (≥168 h) hemostatic stabilities of Canadian [...] Read more.
Despite the importance of the hemostatic properties of reconstituted freeze-dried plasma (FDP) for trauma resuscitation, few studies have been conducted to determine its post-reconstitution hemostatic stability. This study aimed to assess the short- (≤24 h) and long-term (≥168 h) hemostatic stabilities of Canadian and German freeze-dried plasma (CFDP and LyoPlas) after reconstitution and storage under different conditions. Post-reconstitution hemostatic profiles were determined using rotational thromboelastometry (ROTEM) and a Stago analyzer, as both are widely used as standard methods for assessing the quality of plasma. When compared to the initial reconstituted CFDP, there were no changes in ROTEM measurements for INTEM maximum clot firmness (MCF), EXTEM clotting time (CT) and MCF, and Stago measurements for prothrombin time (PT), partial thromboplastin time (PTT), D-dimer concentration, plasminogen, and protein C activities after storage at 4 °C for 24 h and room temperature (RT) (22–25 °C) for 4 h. However, an increase in INTEM CT and decreases in fibrinogen concentration, factors V and VIII, and protein S activities were observed after storage at 4 °C for 24 h, while an increase in factor V and decreases in antithrombin and protein S activities were seen after storage at RT for 4 h. Evaluation of the long-term stability of reconstituted LyoPlas showed decreased stability in both global and specific hemostatic profiles with increasing storage temperatures, particularly at 35 °C, where progressive changes in CT and MCF, PT, PTT, fibrinogen concentration, factor V, antithrombin, protein C, and protein S activities were seen even after storage for 4 h. We confirmed the short-term stability of CFDP in global hemostatic properties after reconstitution and storage at RT, consistent with the shelf life of reconstituted LyoPlas. The long-term stability analyses suggest that the post-reconstitution hemostatic stability of FDP products would decrease over time with increasing storage temperature, with a significant loss of hemostatic functions at 35 °C compared to 22 °C or below. Therefore, the shelf life of reconstituted FDP should be recommended according to the storage temperature. Full article
(This article belongs to the Special Issue Freeze-Dried Plasma for Major Trauma: Trends and Applications)
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