The role of factor V in trauma-induced coagulopathy: an observational and experimental study
Background: In bleeding patients with trauma-induced coagulopathy (TIC), factor (F)V becomes depleted, which may not be corrected with existing treatment strategies. It is currently unknown whether supplementing FV or FVa improves TIC. Objectives: To explore the relationship between FV activity and...
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Elsevier
2025-05-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2475037925001815 |
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| author | Pieter H. Sloos Romein W.G. Dujardin Joost C.M. Meijers Christine Gaarder Ross Davenport Simon Stanworth Pär I. Johansson Jakob Stensballe Marc Maegele Nicole P. Juffermans Derek J.B. Kleinveld |
| author_facet | Pieter H. Sloos Romein W.G. Dujardin Joost C.M. Meijers Christine Gaarder Ross Davenport Simon Stanworth Pär I. Johansson Jakob Stensballe Marc Maegele Nicole P. Juffermans Derek J.B. Kleinveld |
| author_sort | Pieter H. Sloos |
| collection | DOAJ |
| description | Background: In bleeding patients with trauma-induced coagulopathy (TIC), factor (F)V becomes depleted, which may not be corrected with existing treatment strategies. It is currently unknown whether supplementing FV or FVa improves TIC. Objectives: To explore the relationship between FV activity and mortality in trauma patients, and to investigate the effect of FV(a) supplementation in addition to other treatment strategies in an in vitro model of TIC. Methods: The association between FV activity and mortality was studied using an international prospective cohort study of trauma patients. In an in vitro whole blood and plasma model of TIC, the effect of FV(a) on rotational thromboelastometry and fibrin formation was studied. Effects of FV(a) were evaluated either as a standalone therapy or as adjunctive therapy in combination with tranexamic acid, fibrinogen concentrate, and/or prothrombin complex concentrate. Results: A total of 1285 patients were included, with a median injury severity score of 16 (interquartile range: 8-26). Decreased FV activity was associated with increased mortality. In the whole blood TIC model, FVa increased maximum clot firmness and reduced fibrinolysis, both as a single and combination therapy. In the plasma TIC model, with lower tissue factor concentrations than in the whole blood model, FV(a) prolonged clotting times, both as a single treatment and in combination with other treatments. Conclusion: FV depletion after trauma is associated with increased mortality. In an in vitro model of TIC, FV(a) results in procoagulant, antifibrinolytic, and anticoagulant effects. Further research is highly warranted. |
| format | Article |
| id | doaj-art-9ce6c387b3a14c44a583e10293e5f77e |
| institution | DOAJ |
| issn | 2475-0379 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj-art-9ce6c387b3a14c44a583e10293e5f77e2025-08-20T03:04:46ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792025-05-019410285710.1016/j.rpth.2025.102857The role of factor V in trauma-induced coagulopathy: an observational and experimental studyPieter H. Sloos0Romein W.G. Dujardin1Joost C.M. Meijers2Christine Gaarder3Ross Davenport4Simon Stanworth5Pär I. Johansson6Jakob Stensballe7Marc Maegele8Nicole P. Juffermans9Derek J.B. Kleinveld10Department of Intensive Care Medicine, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the NetherlandsDepartment of Intensive Care Medicine, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Department of Anesthesiology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the NetherlandsDepartment of Experimental Vascular Medicine, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Pulmonary Hypertension and Thrombosis, Amsterdam, the NetherlandsDepartment of Traumatology, Oslo University Hospital, Oslo, NorwayDepartment of Trauma Surgery, Barts and the London School of Medicine and Dentistry, London, United KingdomNational Health Service Blood and Transplant/Oxford University Hospital NHS Trust, John Radcliffe Hospital, Oxford, United KingdomDepartment of Anesthesiology and Trauma Center, Center for Head and Orthopedics, Section for Transfusion Medicine, Copenhagen University Hospital Rigshospitalet, Capital Region Blood Bank, Copenhagen, DenmarkDepartment of Anesthesiology and Trauma Center, Center for Head and Orthopedics, Section for Transfusion Medicine, Copenhagen University Hospital Rigshospitalet, Capital Region Blood Bank, Copenhagen, DenmarkDepartment of Traumatology and Orthopedic Surgery, Cologne–Merheim Medical Center, University of Witten/Herdecke, Cologne, GermanyAmsterdam Institute for Infection and Immunity, Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, the NetherlandsDepartment of Intensive Care Medicine, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, the Netherlands; Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands; Correspondence Derek J.B. Kleinveld, Department of Anesthesiology, Erasmus Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.Background: In bleeding patients with trauma-induced coagulopathy (TIC), factor (F)V becomes depleted, which may not be corrected with existing treatment strategies. It is currently unknown whether supplementing FV or FVa improves TIC. Objectives: To explore the relationship between FV activity and mortality in trauma patients, and to investigate the effect of FV(a) supplementation in addition to other treatment strategies in an in vitro model of TIC. Methods: The association between FV activity and mortality was studied using an international prospective cohort study of trauma patients. In an in vitro whole blood and plasma model of TIC, the effect of FV(a) on rotational thromboelastometry and fibrin formation was studied. Effects of FV(a) were evaluated either as a standalone therapy or as adjunctive therapy in combination with tranexamic acid, fibrinogen concentrate, and/or prothrombin complex concentrate. Results: A total of 1285 patients were included, with a median injury severity score of 16 (interquartile range: 8-26). Decreased FV activity was associated with increased mortality. In the whole blood TIC model, FVa increased maximum clot firmness and reduced fibrinolysis, both as a single and combination therapy. In the plasma TIC model, with lower tissue factor concentrations than in the whole blood model, FV(a) prolonged clotting times, both as a single treatment and in combination with other treatments. Conclusion: FV depletion after trauma is associated with increased mortality. In an in vitro model of TIC, FV(a) results in procoagulant, antifibrinolytic, and anticoagulant effects. Further research is highly warranted.http://www.sciencedirect.com/science/article/pii/S2475037925001815hemostasisblood coagulation factorsfactor Vwounds and Injurieshemorrhage |
| spellingShingle | Pieter H. Sloos Romein W.G. Dujardin Joost C.M. Meijers Christine Gaarder Ross Davenport Simon Stanworth Pär I. Johansson Jakob Stensballe Marc Maegele Nicole P. Juffermans Derek J.B. Kleinveld The role of factor V in trauma-induced coagulopathy: an observational and experimental study Research and Practice in Thrombosis and Haemostasis hemostasis blood coagulation factors factor V wounds and Injuries hemorrhage |
| title | The role of factor V in trauma-induced coagulopathy: an observational and experimental study |
| title_full | The role of factor V in trauma-induced coagulopathy: an observational and experimental study |
| title_fullStr | The role of factor V in trauma-induced coagulopathy: an observational and experimental study |
| title_full_unstemmed | The role of factor V in trauma-induced coagulopathy: an observational and experimental study |
| title_short | The role of factor V in trauma-induced coagulopathy: an observational and experimental study |
| title_sort | role of factor v in trauma induced coagulopathy an observational and experimental study |
| topic | hemostasis blood coagulation factors factor V wounds and Injuries hemorrhage |
| url | http://www.sciencedirect.com/science/article/pii/S2475037925001815 |
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