{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:07:09Z","timestamp":1789657629368,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemorrhagic shock is the leading cause of preventable prehospital trauma deaths. While arginine vasopressin (AVP) is a well\u2010known hormone with vasopressor effects, its potential for hemodynamic stabilization in prehospital hemorrhagic shock remains underexplored. This study investigated intramuscular (IM) AVP during hemorrhagic shock to evaluate its feasibility and efficacy for prehospital trauma resuscitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>\n                      In this randomized, controlled, double\u2010blinded trial, 16 swine (mean [standard deviation, SD] weight 56.2 [3.8]\u2009kg) underwent a mean (SD) 1205 (124) mL Class III hemorrhage for 45\u2009min and 45\u2009min of hypotension. Animals were randomized to 40\u2009U IM AVP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) or NaCl (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099), followed immediately by 500\u2009mL autologous whole blood transfusion over 30 and 120\u2009min posttransfusion monitoring of hemodynamic, respiratory, and metabolic parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AVP increased systolic arterial pressure 30\u2009min after administration (mean increase: 33.5\u2009mmHg vs. 7.5\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and improved cardiac index (CI) 90\u2009min after AVP (mean increase: 19.2% vs. 4.1% decrease,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and stroke volume (mean increase: 37.0% vs. 1.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). These effects normalized by 120\u2009min. AVP did not affect respiratory parameters, oxygen delivery, or consumption. Increased serum AVP confirmed systemic uptake (median 68.7\u2009pg\/mL vs. 10.0\u2009pg\/mL in controls,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IM AVP, combined with whole blood transfusion, transiently stabilized hemodynamics by increasing systemic vascular resistance index, systolic blood pressure, and CI without respiratory compromise. These findings suggest that IM AVP may be a viable intervention for prehospital resuscitation of severe hemorrhagic shock, offering vital short\u2010term stabilization to facilitate transport to definitive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18218","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T01:33:18Z","timestamp":1742779998000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intramuscular vasopressin: A feasible intervention for prehospital hemodynamic stabilization in porcine hemorrhagic shock and whole blood transfusion"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1952-5563","authenticated-orcid":false,"given":"Mattias","family":"Renberg","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset Section for Anesthesiology and Intensive Care, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0894-7288","authenticated-orcid":false,"given":"Tomas","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset Section for Anesthesiology and Intensive Care, Karolinska Institutet  Stockholm Sweden"},{"name":"Rapid Response Car AISAB  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Gellerfors","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology, Section of Anesthesiology and Intensive Care Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Swedish Air Ambulance (SLA)  Mora Sweden"},{"name":"Ambulance Helicopter and Rapid Response Car AISAB  Stockholm 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