Solvent-Detergent Treated Pooled Human Plasma Provides Superior Hemodynamic Stability and Cerebral Tissue Oxygenation Compared to Crystalloid in a Cynomolgus Macaque Model of Traumatic Hemorrhagic Shock.

Background: Clinical trauma studies have demonstrated a long-term survival benefit of early plasma resuscitation compared to crystalloid, with conflicting evidence for improvements in coagulation parameters. To further elucidate resuscitative effects of plasma, we evaluated solvent/detergent-treated pooled human plasma (SDP) in a nonhuman primate model of polytrauma and hemorrhagic shock (PTHS).

Methods: Ten anesthetized male cynomolgus macaques underwent PTHS before randomization to receive 20mL/kg of SDP or Lactated Ringers (LRS) at the end of shock (T0). All animals underwent standardized simulated hospital resuscitation at T60, with injury repair and 50% shed blood return followed by 300% shed blood volume in LRS. Data analyzed via t-tests and two-way repeated measures ANOVA. Significance=P<0.05.

Results: No significant group differences were observed in shock time, blood loss, or resuscitative fluid volumes. At T0, mean arterial pressure (MAP), systolic blood pressure (SBP), and cerebral oxygen saturation (CrSO₂) significantly decreased in both groups. While both groups normalized MAP and SBP by T5, only SDP maintained these levels until the simulated hospital period. CrSO₂ remained significantly lower in the LRS group until simulated hospital resuscitation. SDP significantly improved colloid osmotic pressure (COP) compared to LRS. Coagulation analysis showed increased fibrinogen concentration and coagulation factor activities in the SDP group compared to LRS.

Conclusion: SDP provides significantly more stable hemodynamic function following PTHS compared to LRS, maintaining MAP, SBP, and CrSO₂ despite both fluids lacking oxygen-carriers, likely due to increased COP, while supporting coagulation. These findings support SDP as a viable resuscitation product for PTHS in austere settings.