High-dimensional analysis of injured patients reveals distinct circulating proteomic profiles in plasma vs. whole blood resuscitation
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.
Authors
- Christopher D. Barrett (ORCID: https://orcid.org/0000-0001-9720-8155)
- Erika P. Ong (ORCID: https://orcid.org/0000-0002-2785-0182)
- Upendra K. Kar (ORCID: https://orcid.org/0000-0003-4065-0860)
- Mark H. Yazer (ORCID: https://orcid.org/0000-0001-6740-2758)
- Hamed Moheimani (ORCID: https://orcid.org/0000-0001-7855-5143)
- Matthew D. Neal (ORCID: https://orcid.org/0000-0001-8931-6236)
- Jeremy W. Cannon (ORCID: https://orcid.org/0000-0002-2969-9316)
- Francis Xavier Guyette (ORCID: https://orcid.org/0000-0002-9151-4896)
- Nicholas Namias (ORCID: https://orcid.org/0000-0001-7021-2250)
- Jennifer L. Darby
- Timothy R. Billiar (ORCID: https://orcid.org/0000-0002-2949-0811)
- Stephen R. Wisniewski (ORCID: https://orcid.org/0000-0002-3877-9860)
- Jishnu Das (ORCID: https://orcid.org/0000-0002-5747-064X)
- Bryan A. Cotton (ORCID: https://orcid.org/0000-0003-4184-6742)
- Xuejing Sun
- Martin A. Schreiber (ORCID: https://orcid.org/0000-0002-4430-6779)
- Jason L. Sperry (ORCID: https://orcid.org/0000-0003-3917-6479)
- Mehves Ozel
- Joseph P. Minei
- Ernest E. Moore
- Tunde Oyebamiji
Institutions
- Nebraska Medical Center (US)
- University of Miami (US)
- Uniformed Services University of the Health Sciences (US)
- University of Pittsburgh (US)
- Denver Health Medical Center (US)
- Jackson Memorial Hospital (US)
- University of Colorado Health (US)
- University of Pittsburgh Medical Center (US)
- University of Nebraska Medical Center (US)
- University of Pennsylvania (US)
- The University of Texas Southwestern Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- University of Colorado Denver (US)
Publication Details
- Journal
- Cell Reports Medicine
- Published
- 2025-03-01
- DOI
- https://doi.org/10.1016/j.xcrm.2025.102022
- Citations
- 3
- Primary Topic
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Type
- article
- Field-Weighted Citation Impact
- 4.64
Funders
- U.S. Department of Defense
- CSL Behring
- Haemonetics Corporation
- National Institutes of Health
- National Heart, Lung, and Blood Institute
- National Institute of General Medical Sciences