دورية أكاديمية
RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA: ZONE 1 REPERFUSION-INDUCED COAGULOPATHY.
| العنوان: | RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA: ZONE 1 REPERFUSION-INDUCED COAGULOPATHY. |
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| المؤلفون: | Cralley AL; Department of Surgery, University of Colorado, Aurora, Colorado., Moore EE, LaCroix I; Department of Proteomics and Metabolomics, University of Colorado, Aurora, Colorado., Schaid TJ; Department of Surgery, University of Colorado, Aurora, Colorado., Thielen O; Department of Surgery, University of Colorado, Aurora, Colorado., Hallas W; Department of Surgery, University of Colorado, Aurora, Colorado., Hom P; Department of Surgery, University of Colorado, Aurora, Colorado., Mitra S; Department of Surgery, University of Colorado, Aurora, Colorado., Kelher M; Vitalant Research Institute, Denver, Colorado., Hansen K; Department of Proteomics and Metabolomics, University of Colorado, Aurora, Colorado., Cohen M; Department of Surgery, University of Colorado, Aurora, Colorado., Silliman C, Sauaia A; Department of Health Systems, Management and Policy, School of Public Health, University of Colorado, Aurora, Colorado., Fox CJ; Department of Vascular Surgery, University of Maryland, Baltimore, Maryland. |
| المصدر: | Shock (Augusta, Ga.) [Shock] 2024 Feb 01; Vol. 61 (2), pp. 322-329. Date of Electronic Publication: 2023 Dec 28. |
| نوع المنشور: | Randomized Controlled Trial, Veterinary; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9421564 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-0514 (Electronic) Linking ISSN: 10732322 NLM ISO Abbreviation: Shock Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2002- : Philadelphia : Lippincott Williams & Wilkins Original Publication: Augusta, GA : BioMedical Press, [1994- |
| مواضيع طبية MeSH: | Blood Coagulation Disorders* , Balloon Occlusion* , Multiple Trauma*, Animals ; Swine ; Tissue Plasminogen Activator ; Proteomics ; Aorta |
| مستخلص: | Abstract: Objective: We sought to identify potential drivers behind resuscitative endovascular balloon occlusion of the aorta (REBOA) induced reperfusion coagulopathy using novel proteomic methods. Background: Coagulopathy associated with REBOA is poorly defined. The REBOA Zone 1 provokes hepatic and intestinal ischemia that may alter coagulation factor production and lead to molecular pathway alterations that compromises hemostasis. We hypothesized that REBOA Zone 1 would lead to reperfusion coagulopathy driven by mediators of fibrinolysis, loss of coagulation factors, and potential endothelial dysfunction. Methods: Yorkshire swine were subjected to a polytrauma injury (blast traumatic brain injury, tissue injury, and hemorrhagic shock). Pigs were randomized to observation only (controls, n = 6) or to 30 min of REBOA Zone 1 (n = 6) or REBOA Zone 3 (n = 4) as part of their resuscitation. Thromboelastography was used to detect coagulopathy. ELISA assays and mass spectrometry proteomics were used to measure plasma protein levels related to coagulation and systemic inflammation. Results: After the polytrauma phase, balloon deflation of REBOA Zone 1 was associated with significant hyperfibrinolysis (TEG results: REBOA Zone 1 35.50% versus control 9.5% vs. Zone 3 2.4%, P < 0.05). In the proteomics and ELISA results, REBOA Zone 1 was associated with significant decreases in coagulation factor XI and coagulation factor II, and significant elevations of active tissue plasminogen activator, plasmin-antiplasmin complex complexes, and syndecan-1 (P < 0.05). Conclusion: REBOA Zone 1 alters circulating mediators of clot formation, clot lysis, and increases plasma levels of known markers of endotheliopathy, leading to a reperfusion-induced coagulopathy compared with REBOA Zone 3 and no REBOA. Competing Interests: EEM has patents pending related to coagulation and fibrinolysis diagnostics and therapeutic fibrinolytics and was a cofounder of ThromboTherepeutics. EEM has received grant support from Haemonetics, Hemosonics, Werfen, Stago, and Prytime outside the submitted work. CJF is a clinical consultant for Prytime Medical. The remaining authors report no conflict of interests. (Copyright © 2023 by the Shock Society.) |
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| معلومات مُعتمدة: | RM1 GM131968 United States GM NIGMS NIH HHS; T32 GM008315 United States GM NIGMS NIH HHS |
| المشرفين على المادة: | EC 3.4.21.68 (Tissue Plasminogen Activator) |
| تواريخ الأحداث: | Date Created: 20240226 Date Completed: 20240227 Latest Revision: 20240524 |
| رمز التحديث: | 20240524 |
| مُعرف محوري في PubMed: | PMC10955717 |
| DOI: | 10.1097/SHK.0000000000002299 |
| PMID: | 38407818 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1540-0514 |
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| DOI: | 10.1097/SHK.0000000000002299 |