Abstract Number: PB1274
Meeting: ISTH 2022 Congress
Background: Severe injury may induce hemolysis, releasing intracellular RBC proteins, such as arginase-1. Transfused RBC’s can lyse in the trauma-associated, thromboinflammatory milieu, which may have serious clinical implications given the frequency of blood transfusion after trauma. There are currently no studies examining the relationship between trauma-induced hemolysis and clinical outcomes.
Aims: Use comprehensive proteomics to link trauma-induced hemolysis to outcomes and unmask potential mechanisms of post-injury organ dysfunction.
Methods: Blood was collected from injured patients at a Level I Trauma Center. Proteomics were performed using targeted liquid chromatography coupled with mass spectrometry. Intracellular RBC proteins as well as haptoglobin, L-arginine, and ornithine were measured at multiple timepoints. Unpaired t-tests and multiple linear regression were used to analyze association between injury, hemolysis, and outcomes.
Results: Intracellular RBC proteins were elevated on emergency department (ED) arrival through 24hr versus healthy controls. Haptoglobin decreased over 24hr in those severely injured with shock (NISS >25, base excess
Conclusion(s): Trauma and shock result in intravascular hemolysis, which is exacerbated by RBC transfusions and associated with worse outcomes. Arginase-1 release with depletion of L-arginine necessary for nitric oxide production may contribute to organ dysfunction. This study raises important questions about how the trauma milieu causes hemolysis, which may be exacerbated by exogenous RBC’s given during resuscitation. Additional investigation is needed on endogenous versus transfused RBC lysis in trauma, which may unveil critical implications for resuscitation.
Research was supported by NIH 1RM1GM131968-01.
To cite this abstract in AMA style:Schaid T, D'Alessandro A, Moore E, Silliman C, Sauaia A, DeBot M, Erickson C, Lacroix I, Cralley A, Banerjee A, Jones K, Ghasabyan A, Mitra S, Cohen M, Hansen K. Trauma Induces Intravascular Hemolysis, which is Associated with Adverse Clinical Outcomes: Potential Role of Released Arginase-1, Depletion of L-arginine, and Reduced Production of Nitric Oxide [abstract]. https://abstracts.isth.org/abstract/trauma-induces-intravascular-hemolysis-which-is-associated-with-adverse-clinical-outcomes-potential-role-of-released-arginase-1-depletion-of-l-arginine-and-reduced-production-of-nitric-oxide/. Accessed February 27, 2024.
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