Fig 1.
Clot initiation indexed by the R time on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PEG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted). *P<0.05.
Fig 2.
Clot amplification indexed by the k time on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted). *P<0.05.
Fig 3.
Clot propagation indexed by the Angle variable on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted). *P<0.05.
Fig 4.
Clot strength and maximum size indexed by the MA on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted). *P<0.05.
Fig 5.
Clot lysis indexed by the LY30 on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted).
Fig 6.
Coagulation Index as measured by the CI on TEG in blood from healthy volunteers, trauma patients, and volunteers in a PEG-20k dose-response series.
The CI is a mathematical compilation of other TEG outcome variables (R, K, Angle, and MA). All TEG outcomes represents 25 healthy volunteers, 9 trauma patients, and 9 volunteers for dose-response studies. Whole citrate preserved blood was immediately diluted 10% with a saline vehicle (NS), 6% solution of Hextend (HS), and Polyethylene Glycol-20k (PG) at concentrations of 10%, 7.5%, or 5% and assayed by full thromboelastography (TEG) within 2–3 hours of blood draw in a matched design with saline always serving as control to the resuscitative fluid. All values are expressed in a box and whiskers standard format where the bar in the box is the sample median value, the lower border of the box is the value demarcating the 1st and second interquartile range, the upper border of the box is the value demarcating the 3rd and 4th interquartile range, and the upper and lower whiskers are the samples highest and lowest values, respectively. The shaded box represents the known normal ranges for the TEG values. WB = whole blood (undiluted). Tracings on the left are representative TEG tracings obtained from all three LVR solutions used in this study (NS, PEG-20k, and HES). *P<0.05.
Fig 7.
Acute resuscitation outcomes in a study in rats subjected to severe hemorrhagic shock and low volume resuscitation with NS (saline) controls, or 7.5% and 10% PEG-20k.
All LVR solutions were given at a volume equal to 10% of the estimated blood volume of the animals. The low volume resuscitation times (LVR) were measured and shown in panel A, which is an index of tolerance to the low volume state (see Methods for details). The end or terminal lactate values are shown in panel B, which are the values at the end of the LVR period (or 240 minutes in the PEG groups), and the terminal mean arterial blood pressure measured at the end of the LVR period in panel C. Values are mean +/- standard deviation, n = 5 for NS and 10% PEG-20k and n = 4 for 7.5% PEG-20k. Baseline MAP before hemorrhage was 101 +/- 18 mmHg and baseline lactate before hemorrhage was 0.9 +/- 0.2 mM/L, *P<0.05 relative to both PEG groups.