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Ichikawa J, Iba T, Okazaki R, Fukuda T, Kodaka M, Komori M, Levy JH. Hemostatic capability of ultrafiltrated fresh frozen plasma compared to cryoprecipitate. Sci Rep 2023; 13:21579. [PMID: 38062086 PMCID: PMC10703847 DOI: 10.1038/s41598-023-48759-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
This in vitro study evaluated the potential hemostatic effect of fresh frozen plasma (FFP) ultrafiltration on clotting factors, coagulation parameters, and plasma properties. ABO-specific units of FFP (n = 40) were prepared for the concentrated FFP and cryoprecipitate. Plasma water was removed from FFP by ultrafiltration using a dialyzer with a pump running at a 300 mL/min. The aliquot of each concentrated FFP after 50, 100, 200, and 250 mL of fluid removal were measured the standard coagulation assay, clotting activity, and plasma properties to compare those parameters of cryoprecipitate. Concentrated FFP contained 36.5% of fibrinogen in FFP with a mean concentration of 7.2 g/L, lower than the cryoprecipitate level. The levels of factor VIII (FVIII), von Willebrand factor (VWF):antigen (Ag), and VWF:ristocetin cofactor (RCo) were also lower in concentrated FFP, whereas the levels of factor V, factor IX, factor XIII, antithrombin and albumin was higher in concentrated FFP. Maximum clot firmness (MCF) in thromboelastometry was approximately one-half of that in cryoprecipitate. Although the levels of VWF:Ag, VWF:RCo, and FVIII differed depending on the ABO blood types, fibrinogen levels, and MCF were not significantly different among the ABO blood groups in FFP and concentrated FFP.
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Affiliation(s)
- Junko Ichikawa
- Department of Anesthesiology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, 123-8858, Japan.
| | - Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryouta Okazaki
- Department of Anesthesiology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, 123-8858, Japan
| | - Tomoki Fukuda
- Department of Anesthesiology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, 123-8858, Japan
| | - Mitsuharu Kodaka
- Department of Anesthesiology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, 123-8858, Japan
| | - Makiko Komori
- Department of Anesthesiology, Tokyo Women's Medical University, Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, 123-8858, Japan
| | - Jerrold H Levy
- Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA
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Valenta J, Hlavackova A, Stach Z, Stikarova J, Havlicek M, Michalek P. Fibrinogenolysis in Venom-Induced Consumption Coagulopathy after Viperidae Snakebites: A Pilot Study. Toxins (Basel) 2022; 14:toxins14080538. [PMID: 36006200 PMCID: PMC9415103 DOI: 10.3390/toxins14080538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 01/23/2023] Open
Abstract
Envenomations that are caused by Viperidae snakebites are mostly accompanied by venom-induced consumption coagulopathy (VICC) with defibrination. The clinical course of VICC is well described; however, reports about its detailed effects in the hemocoagulation systems of patients are sparse. In this pilot study, we prospectively analyzed the changes in plasma fibrinogen that were caused by the envenomation of six patients by five non-European Viperidae snakes. Western blot analysis was employed and fibrinogen fragments were visualized with the use of specific anti-human fibrinogen antibodies. All of the studied subjects experienced hypo- or afibrinogenemia. The western blot analysis demonstrated fibrinogenolysis of the fibrinogen chains in all of the cases. Fibrinogenolysis was considered to be a predominant cause of defibrination in Crotalus, Echis, and Macrovipera envenomation; while, in the cases of VICC that were caused by Atheris and Calloselasma envenomation, the splitting of the fibrinogen chains was present less significantly.
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Affiliation(s)
- Jiri Valenta
- Department of Anaesthesiology and Intensive Medicine, Toxinology Center, First Medical Faculty, Charles University, General University Hospital, U Nemocnice 499/2, 128 08 Prague, Czech Republic
| | - Alzbeta Hlavackova
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 128 00 Prague, Czech Republic
- Correspondence: (A.H.); (P.M.); Tel.: +420-22197-7344 (A.H.); +420-22496-2666 (P.M.)
| | - Zdenek Stach
- Department of Anaesthesiology and Intensive Medicine, Toxinology Center, First Medical Faculty, Charles University, General University Hospital, U Nemocnice 499/2, 128 08 Prague, Czech Republic
| | - Jana Stikarova
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 128 00 Prague, Czech Republic
| | - Marek Havlicek
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 128 00 Prague, Czech Republic
| | - Pavel Michalek
- Department of Anaesthesiology and Intensive Medicine, Toxinology Center, First Medical Faculty, Charles University, General University Hospital, U Nemocnice 499/2, 128 08 Prague, Czech Republic
- Correspondence: (A.H.); (P.M.); Tel.: +420-22197-7344 (A.H.); +420-22496-2666 (P.M.)
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