Item Details

title

HEMOLYSIS INDUCED PLATELET ACTIVATION AND REMOVAL OF CELL FREE HEMOGLOBIN USING POROUS ZINC BEADS

author

Simms, Kelli

abstract

In massive transfusion protocols, red blood cells (RBCs) are commonly transfused in tandem with platelets and plasma. Despite evidence supporting the early use of platelets for hemorrhage control, RBCs continue to be the primary transfusion unit administered to trauma patients. However, this could potentially exacerbate coagulopathy commonly seen in trauma patients. As RBCs age during storage, they experience a variety of storage lesions including the lysis of RBCs leading to the accumulation of hemolysis. Cell-free hemoglobin in hemolysis has been shown to be a powerful platelet activator, both in vivo and in vitro. Administering large volumes of aged RBCs to coagulopathic trauma patients could prematurely activate both endogenous and exogenous platelets, inhibiting hemostasis. I hypothesize that the administration of large volumes of stored RBCs will prematurely activate platelets, leading to dysfunctional platelet activity and clotting functionality. To test this hypothesis, three major aims have been identified: 1) quantify in vitro the extent of hemolysis-induced platelet activation using packed RBCs added to fresh and pooled platelet units, 2) analyze the effect of hemolysis on clotting functionality in vivo through a retrospective analysis of the PROPPR trial and 3) develop a method/device capable of removing cell-free hemoglobin from RBC hemolysis prior to transfusion. These three aims will allow for the quantification of the effect of hemolysis-induced platelet activation on hemostasis in patients receiving massive transfusions following trauma.

subject

Hb

hemolysis

platelet

TIC

transfusion

zinc resin

contributor

Rahbar, Elaheh (committee chair)

Brown, Philip (committee member)

Cardenas, Jessica (committee member)

Guthold, Martin (committee member)

Hall, Adam (committee member)

Kim-Shapiro, Daniel (committee member)

date

2019-05-24T08:35:46Z (accessioned)

2021-05-23T08:30:13Z (available)

2019 (issued)

degree

Biomedical Engineering (discipline)

embargo

2021-05-23 (terms)

identifier

http://hdl.handle.net/10339/93958 (uri)

language

en (iso)

publisher

Wake Forest University

type

Dissertation