{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T12:19:23Z","timestamp":1762604363136},"reference-count":0,"publisher":"Rambam Health Corporation","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rambam Maimonides Med J"],"abstract":"<jats:p>Background: Blunt traumatic brain injury (bTBI) and uncontrolled hemorrhagic shock (UCHS) are common causes of mortality in polytrauma. We studied the influence of fresh frozen plasma (FFP) resuscitation in a rat model with both bTBI and UCHS before achieving hemorrhage control.  Methods: The bTBI was induced by an external weight drop (200 g) onto the bare skull of anesthetized male Lewis (Lew\/SdNHsd) rats; UCHS was induced by resection of two-thirds of the rats\u2019 tails. Fifteen minutes following trauma, bTBI+UCHS rats underwent resuscitation with FFP or lactated Ringer\u2019s solution (LR). Eight groups were evaluated: (1) Sham; (2) bTBI; (3) UCHS; (4) UCHS+FFP; (5) UCHS+LR; (6) bTBI+UCHS; (7) bTBI+UCHS+FFP; and (8) bTBI+UCHS+LR. Bleeding volume, hematocrit, lactate, mean arterial pressure (MAP), heart rate, and mortality were measured.  Results: The study included 97 rats that survived the immediate trauma. Mean blood loss up to the start of resuscitation was similar among UCHS only and bTBI+UCHS rats (P=0.361). Following resuscitation, bleeding was more extensive in bTBI+UCHS+FFP rats (5.2 mL, 95% confidence interval [CI] 3.7, 6.6) than in bTBI+UCHS+LR rats (2.5 mL, 95% CI 1.2, 3.8) and bTBI+UCHS rats (1.9 mL, 95% CI -0.2, 3.9) (P=0.005). Similarly, non-significant increases in blood loss were observed in UCHS+FFP rats (P=0.254). Overall mortality increased if bleeding was above 4.5 mL (92.3% versus 8%; P&lt;0.001). Mortality was 83.3% (10\/12) in bTBI+UCHS+FFP rats, 41.7% (5\/12) in bTBI+UCHS+LR rats, and 64.3% (9\/14) in bTBI+UCHS rats.  Conclusion: The bTBI did not exacerbate bleeding in rats undergoing UCHS. Compared to LR, FFP resuscitation was associated with a significantly increased blood loss in bTBI+UCHS rats.<\/jats:p>","DOI":"10.5041\/rmmj.10489","type":"journal-article","created":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T09:02:41Z","timestamp":1674982961000},"page":"e0002","source":"Crossref","is-referenced-by-count":2,"title":["Fresh Frozen Plasma Increases Hemorrhage in Blunt Traumatic Brain Injury and Uncontrolled Hemorrhagic Shock"],"prefix":"10.5041","volume":"14","author":[{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilla","family":"Abergel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion-Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miri","family":"Bidder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion-Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itamar","family":"Ashkenazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel and Technion\u2013Israel Institute of Technology, Haifa, Israel; Department of Anesthesiology, Hillel Yaffel Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion-Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Reytman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion-Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Anesthesiology, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Alfici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion-Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Clinical Professor Emeritus, Department of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael M.","family":"Krausz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Surgical Research Laboratory, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Technion\u2013Israel Institute of Technology, Haifa, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Professor Emeritus, Department of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2983","published-online":{"date-parts":[[2023,1,29]]},"container-title":["Rambam Maimonides Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.rmmj.org.il\/userimages\/1474\/1\/PublishFiles\/1547Article.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T13:34:41Z","timestamp":1675776881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.rmmj.org.il\/issues\/56\/articles\/1547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,29]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,29]]}},"URL":"https:\/\/doi.org\/10.5041\/rmmj.10489","relation":{},"ISSN":["2076-9172"],"issn-type":[{"type":"electronic","value":"2076-9172"}],"subject":[],"published":{"date-parts":[[2023,1,29]]}}}