Abstract
Aim. The study objective was to examine fibrin monomer hemostatic effects in post-traumatic parenchymal hemorrhage in the setting of pharmacologically associated platelet aggregation inhibition. Materials and methods. In the in vivo experimental study on male rabbits, the hemostatic effects of fibrin monomer (FM) (0.25 mg/kg) were evaluated in comparison with tranexamic acid (TA) (15 mg/kg) in post-traumatic parenchymal hemorrhage against the background of preliminary inhibition of platelet aggregation function with acetylsalicylic acid (2.0 mg/kg) and clopidogrel (8.0 mg/kg). Volume and rate of blood loss were estimated, as well as the parameters of the hemostatic system. Results. It has been established that FM versus placebo when administered intravenously 1 hour before the injury can prevent severe bleeding associated with taking antiplatelet agents. The volume of blood loss after FM administration decreased in median by 6.0 times, the rate of blood loss – by 5.9 times, and when using TA – by 2.4 (Р FM -TA < 0.02) and 4.8 times respectively. The hemostatic effects of TA were realized when the hemostatic balance was shifted towards the increased fibrin formation (an increase in the level of D-dimer in the blood plasma). The use of FM was not accompanied by any significant changes in the blood coagulation system. Conclusion. The fibrin monomer at a dose of 0.25 mg/kg i.v. is capable of preventing severe posttraumatic parenchymal bleeding caused by the combined use of drugs with different antiplatelet action. The phenomenon is not completely clear and needs to be analyzed in further research. The mechanism of hemostatic effects associated with FM is currently being studied.
Highlights
) при нанесении дозированной травмы печени в условиях in vivo [6, 7]
It has been established that fibrin monomer (FM) versus placebo when administered intravenously 1 hour before the injury can prevent severe bleeding associated with taking antiplatelet agents
The volume of blood loss after FM administration decreased in median by 6.0 times, the rate of blood loss – by 5.9 times, and when using tranexamic acid (TA) – by 2.4 (РFM-TA < 0.02) and 4.8 times respectively
Summary
Изучить гемостатические эффекты фибрин-мономера (ФМ) при посттравматическом паренхиматозном кровотечении на фоне фармакологически обусловленного угнетения агрегационной функции тромбоцитов. В экспериментах in vivo на кроликах-самцах оценивали гемостатические эффекты фибрин-мономера (0,25 мг/кг) в сравнении с транексамовой кислотой (ТК) (15 мг/кг) при посттравматическом паренхиматозном кровотечении на фоне предварительного угнетения агрегационной функции тромбоцитов ацетилсалициловой кислотой (2,0 мг/кг) и клопидогрелем (8,0 мг/кг). Установлено, что ФМ в сравнении с плацебо при внутривенном введении за 1 ч до травмы способен профилактировать тяжелое кровотечение, связанное с приемом антиагрегантов. Гемостатические эффекты ТК реализовывались при смещении гемостатического равновесия в сторону усиления фибринообразования (увеличение уровня D-димера в плазме крови). Фибрин-мономер в дозе 0,25 мг/кг способен при внутривенном введении профилактировать тяжелое посттравматическое паренхиматозное кровотечение, вызываемое сочетанным приемом препаратов, обладающих различными механизмами антиагрегантного действия. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Исследование выполнено за счет средств гранта РФФИ (No 18-415220001), при финансовой поддержке ООО фирмы «Технология-Стандарт» и ФГБОУ ВО АГМУ МЗ России
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