Past meets present: Reviving 80‐year‐old Canadian dried serum from World War II and its significance in advancing modern freeze‐dried plasma for prehospital management of haemorrhage

Author:

Singh Kanwal12ORCID,Peng Henry T.3ORCID,Moes Katy3,Kretz Colin A.4ORCID,Beckett Andrew12ORCID

Affiliation:

1. Trauma and Acute Care Surgery, Faculty of Medicine, St. Michael's Hospital University of Toronto Toronto Ontario Canada

2. Canadian Forces Health Services Ottawa Ontario Canada

3. Defence Research and Development Canada, Toronto Research Centre Toronto Ontario Canada

4. Department of Medicine Thrombosis and Atherosclerosis Research Institute, McMaster University Hamilton Ontario Canada

Abstract

SummaryDuring World War II, Charles H. Best utilized Charles R. Drew's plasma isolation and drying technique to lead Canada's initiative to provide dried serum as a means of primary resuscitation for British casualties on the frontlines. Serum was likely utilized over plasma for its volume expansion properties without the risk of clotting during prolonged storage. We reconstituted dried serum from 1943 and discovered intact albumin, as well as anti‐thrombin, plasminogen, protein C and protein S activity. Proteomic analysis identified 71 proteins, most prominent being albumin, and positive for hepatitis B by serological testing. Transmission of blood‐borne diseases ended the programme, until modern advances in testing and pathogen reduction revived this technology. We tested the latest iteration of Canadian freeze‐dried plasma (FDP), which was stored for 4 years, and demonstrated that its clotting capacity remained equivalent to fresh frozen plasma. We recommend that FDP is a strong alternative to contemporary prehospital resuscitation fluids (e.g. normal saline/lactated Ringer's) in managing prehospital haemorrhage where whole blood is unavailable.

Funder

Defence Research and Development Canada

Publisher

Wiley

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