Abstract

Transfusion with blood and blood products are used to treat hemorrhage and improve tissue oxygen delivery. However, since the effects of products such as packed red blood cells (PRBC) on the EG are unknown, we compared the effects of resuscitation with blood products to fresh whole blood (FWB) on cremaster muscle venules. Anesthetized rats subjected to 1h of HS were resuscitated with 1:1 PRBC:LR (Lactated Ringer's), 1:1 wPRBC (washed PRBC):LR or FWB. EG thickness, blood flow and permeability were studied using intravital microscopy. Hemodynamics and coagulation tests (ROTEM) were performed. EG thickness and permeability were restored in the PRBC:LR compared to FWB and SHAM groups, but not in wPRBC:LR (p<0.05). FWB restored coagulation function. EXTEM and FIBTEM clotting times were longer in PRBC:LR and wPRBC:LR. EXTEM clot strength fell >30% in wPRBC: LR. Resuscitation with FWB was superior in reverting coagulopathy, restoring EG, permeability and blood flow. PRBC:LR improved EG and permeability (due to the presence of plasma proteins), but coagulation and blood flow were not recovered. wPRBC:LR did not improve EG or permeability (due to plasma protein removal after washing). Data suggest that removal of residual plasma proteins from PRBC and its association with a protein‐free solution (LR) impair microcirculation and coagulation function in this HS model.Supported by US Army Medical Research & Materiel Command.

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