Lyophilized plasma with ascorbic acid decreases inflammation in hemorrhagic shock

Area of Science:

• Trauma and hemorrhagic shock research
• Immunology and inflammation studies
• Resuscitation strategies

Background:

• High plasma to red blood cell ratios improve survival in massive transfusions.
• Hemorrhagic shock elevates pro-inflammatory cytokines, increasing morbidity and mortality.
• Lyophilized plasma (LP) offers a stable, easily reconstituted alternative to fresh frozen plasma, but its anti-inflammatory role is unclear.

Purpose of the Study:

• To determine if ascorbic acid (AA) or LP itself reduces inflammation in a trauma model.
• To investigate the effect of LP reconstituted with AA, citric acid (CA), or hydrochloric acid (HCl) on inflammatory markers.

Main Methods:

• A swine model of combat-relevant trauma (femur fracture, hemorrhage, liver injury, hypothermia) was used.
• Animals received LP reconstituted with AA, CA, or HCl.
• Serum cytokine levels (IL-6, IL-8, TNF-α) and lung gene expression were analyzed.

Main Results:

• No significant differences in mortality, baseline cytokines, or gene expression were observed.
• Interleukin-6 (IL-6) concentrations increased over time in all groups.
• The AA group showed a significantly lower IL-6 increase at 2 hours compared to CA and HCl groups.

Conclusions:

• Ascorbic acid (AA) demonstrably decreases IL-6 expression in this trauma and resuscitation model.
• These findings suggest AA is the primary component responsible for suppressing inflammation associated with LP resuscitation.
• AA may play a key role in mitigating dysfunctional inflammation following severe trauma.