Faculty, Staff and Student Publications

Language

English

Publication Date

3-18-2025

Journal

Cell Reports Medicine

DOI

10.1016/j.xcrm.2025.102022

PMID

40107243

PMCID

PMC11970397

PubMedCentral® Posted Date

3-18-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Early blood product resuscitation is often essential for optimal trauma care. However, the effects of different products on the underlying trauma-induced coagulopathy and immune dysfunction are not well described. Here, we use high-dimensional analysis and causal modeling in a longitudinal study to explore the circulating proteomic response to plasma as a distinct component versus low-titer O whole blood (LTOWB), which contains plasma. We highlight the differential impacts of plasma and LTOWB on immune mediator levels and the distinct capacity of plasma to modulate coagulation by elevating fibrinogen and factor XIII and reducing platelet factor 4. A higher proportion of plasma in prehospital resuscitation is associated with improved admission time coagulation parameters in patients with severe shock and elevated brain injury markers and reduced post-admission transfusion volumes in those suffering from traumatic brain injury (TBI) and blunt injury. While LTOWB offers broad hemostatic benefits, our findings demonstrate specific advantages of plasma and support individualized transfusion strategies.

Keywords

Humans, Resuscitation, Proteomics, Male, Plasma, Female, Brain Injuries, Traumatic, Adult, Middle Aged, Blood Transfusion, Wounds and Injuries, Blood Coagulation, Proteome, Fibrinogen, Longitudinal Studies, blood coagulation, blood transfusion, fibrinogen, innate immunity, plasma, platelet activation, platelet factor 4, precision medicine, proteomics, traumatic brain injury

Published Open-Access

yes

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