Interindividual variation in platelets and the cardiovascular response to haemorrhage in the pig

TY - JOUR

T1 - Interindividual variation in platelets and the cardiovascular response to haemorrhage in the pig

AU - Zaar, Morten

AU - Secher, Niels H

AU - Gam, Christiane Marie Bourgin

AU - Rasmussen, Peter

AU - Johansson, Pär I

PY - 2011/3/1

Y1 - 2011/3/1

N2 - The platelet count varies two-fold among healthy individuals. Considering the haemostatic role of platelets, this study evaluated the relation between cardiovascular and metabolic responses to uncontrolled haemorrhage and the pretrauma platelet count in pigs. A laceration liver injury was inflicted in 19 pigs (34 ± 3 kg; mean ± SD). To simulate a prehospital setting, fluid administration was delayed 7 min and was then by lactated Ringer. After 30 min, the fluid administered was by hydroxyethyl starch 130/0.4 to stabilize the blood volume. The platelet count for the pigs was 385 (193-507) × 10/l (median (range)). The injury was similar for all pigs and caused a similar blood loss (1.4 ± 0.4 and 2.4 ± 0.4 l after administration of lactated Ringer and hydroxyethyl starch, respectively) and survival time (79 ± 17 min). At baseline, none of the cardiovascular variables were related to the pretrauma platelet count. After administration of lactated Ringer and hydroxyethyl starch, however, mean arterial pressure (R = 0.60, P < 0.001 and R = 0.52, P < 0.01), cardiac output (R = 0.36, P < 0.05 and R = 0.84, P < 0.0001), and thus oxygen delivery (R = 0.38, P < 0.05 and R = 0.92, P < 0.0001) related to the pretrauma platelet count and at 60 min, that was also the case for standard base excess (R = 0.37, P < 0.01), bicarbonate (R = 0.44, P < 0.01), and oxygen uptake (R = 0.51, P < 0.01). Following a liver trauma in pigs, the immediate cardiovascular and metabolic responses were related to the pretrauma platelet count although it did not affect the blood loss. These results support that platelets exert functions during bleeding beyond their importance for clot formation.

AB - The platelet count varies two-fold among healthy individuals. Considering the haemostatic role of platelets, this study evaluated the relation between cardiovascular and metabolic responses to uncontrolled haemorrhage and the pretrauma platelet count in pigs. A laceration liver injury was inflicted in 19 pigs (34 ± 3 kg; mean ± SD). To simulate a prehospital setting, fluid administration was delayed 7 min and was then by lactated Ringer. After 30 min, the fluid administered was by hydroxyethyl starch 130/0.4 to stabilize the blood volume. The platelet count for the pigs was 385 (193-507) × 10/l (median (range)). The injury was similar for all pigs and caused a similar blood loss (1.4 ± 0.4 and 2.4 ± 0.4 l after administration of lactated Ringer and hydroxyethyl starch, respectively) and survival time (79 ± 17 min). At baseline, none of the cardiovascular variables were related to the pretrauma platelet count. After administration of lactated Ringer and hydroxyethyl starch, however, mean arterial pressure (R = 0.60, P < 0.001 and R = 0.52, P < 0.01), cardiac output (R = 0.36, P < 0.05 and R = 0.84, P < 0.0001), and thus oxygen delivery (R = 0.38, P < 0.05 and R = 0.92, P < 0.0001) related to the pretrauma platelet count and at 60 min, that was also the case for standard base excess (R = 0.37, P < 0.01), bicarbonate (R = 0.44, P < 0.01), and oxygen uptake (R = 0.51, P < 0.01). Following a liver trauma in pigs, the immediate cardiovascular and metabolic responses were related to the pretrauma platelet count although it did not affect the blood loss. These results support that platelets exert functions during bleeding beyond their importance for clot formation.

KW - Animals

KW - Blood Platelets

KW - Blood Pressure

KW - Cardiac Output

KW - Hemorrhage

KW - Hemostasis

KW - Hemostatics

KW - Hetastarch

KW - Isotonic Solutions

KW - Liver

KW - Plasma Substitutes

KW - Platelet Count

KW - Swine

U2 - 10.1097/mbc.0b013e3283424896

DO - 10.1097/mbc.0b013e3283424896

M3 - Journal article

C2 - 21150579

SN - 0957-5235

VL - 22

SP - 92

EP - 97

JO - Blood Coagulation and Fibrinolysis

JF - Blood Coagulation and Fibrinolysis

IS - 2

ER -