Changes in coagulation factor XIII activity during resuscitation for hemorrhagic shock

Area of Science:

• Trauma and Emergency Medicine
• Hematology
• Coagulation Science

Background:

• Hemorrhagic shock resuscitation involves complex physiological changes.
• The role of factor XIII (FXIII) activity during this period is not well understood.
• Plasma transfusions are a common intervention, but their impact on FXIII levels is unclear.

Purpose of the Study:

• To evaluate changes in factor XIII (FXIII) activity during resuscitation for hemorrhagic shock.
• To assess the impact of plasma transfusions on FXIII levels in these patients.

Main Methods:

• Single-center observational study of 23 adult patients with hemorrhagic shock.
• Blood samples collected at arrival (T1), hemostasis completion (T2), and day 2 (T3).
• Measured FXIII activity and proportion of patients with adequate FXIII levels (>70%).

Main Results:

• Median FXIII activity was 53% on arrival and did not significantly increase by day 2.
• The proportion of patients with adequate FXIII activity decreased throughout resuscitation (30% at T1, 34% at T2, 21% at T3).
• Plasma transfusion did not significantly improve FXIII activity or the proportion of patients with adequate levels.

Conclusions:

• Factor XIII (FXIII) activity is insufficient in the early stages of hemorrhagic shock.
• Current resuscitation strategies, including plasma transfusion, do not adequately restore or maintain FXIII levels.
• Further research is needed to optimize FXIII management in trauma patients.