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

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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
Simms, Kelli (author)
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)
2019 (issued)
degree
Biomedical Engineering (discipline)
2021-05-23 (liftdate)
embargo
2021-05-23 (terms)
identifier
http://hdl.handle.net/10339/93958 (uri)
language
en (iso)
publisher
Wake Forest University
title
HEMOLYSIS INDUCED PLATELET ACTIVATION AND REMOVAL OF CELL FREE HEMOGLOBIN USING POROUS ZINC BEADS
type
Dissertation

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