Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

Massive bleeding remains one of the leading potentially preventable causes of death in the United States, accounting for more than 50% of mortality rates (Marietta, Marco et al., 2011). Massive transfusion protocol (MTP) is a rapid transfusion of a large amount of blood and blood products (more than ten units of red blood cells in twenty-four hours, or four units of red blood cells in an hour, or any four blood components in 30 minutes) in a short period of time (Thurn et al., 2019). The blood products' ratios included in the massive transfusion protocol are distinct and composed of red blood cells, fresh frozen plasma, and platelets. Developing and establishing electronic records for massive transfusion protocols may improve patient outcomes (Broxton et al., 2017). Using liquid plasma during a massive transfusion protocol may improve patient survival rate by decreasing the blood product delivery time to the patient's bedside and reducing healthcare costs by lowering blood product waste (Beckermann et al., 2022). In this quantitative study, the researcher analyzed retrospective medical records from a Level One Medical Trauma Center in the Southwest United States to answer the research question. Data regarding using liquid plasma in massive blood transfusion outcomes were collected from the hospital records for pre- and post-liquid plasma usage implementation. The study investigated the following research question: For patients who require emergency and massive transfusion, what is the impact of using liquid plasma compared to fresh frozen plasma on blood product wastage and plasma-saving cost one year before and after using liquid plasma?

Committee: Alex Akulli (Committee Chair); Jesse Florang (Committee Member); Gail Frankle (Committee Member) Subjects: Comparative; Health Care; Health Care Management; Health Sciences; Medicine; Pathology; Science Education

Doctor of Philosophy, The Ohio State University, 2023, Chemical Engineering

Oxygen therapeutics are being developed for a variety of applications in transfusion medicine. In order to reduce the side-effects (vasoconstriction, systemic hypertension, and oxidative tissue injury) associated with previous generations of oxygen therapeutics, new strategies are focused on increasing the molecular diameter of hemoglobin obtained from mammalian sources via polymerization and encapsulation. Another approach towards oxygen therapeutic design has centered on using naturally occurring large molecular diameter hemoglobins (i.e., erythrocruorins) derived from annelid sources. Therefore, the goal of Chapter 3 was to purify erythrocruorin from the terrestrial worm Lumbricus terrestris for oxygen therapeutic applications. Tangential flow filtration (TFF) was used as a scalable protein purification platform to obtain a >99% pure LtEc product, which was confirmed by size exclusion high performance liquid chromatography and SDS-PAGE analysis. In vitro characterization concluded that the ultra-pure LtEc product had oxygen equilibrium properties similar to human red blood cells, and a lower rate of auto-oxidation compared to human hemoglobin, both of which should enable efficient oxygen transport under physiological conditions. In vivo evaluation concluded that the ultra-pure product had positive effects on the microcirculation sustaining functional capillary density compared to a less pure product (~86% purity). In summary, we purified an LtEc product with favorable biophysical properties that performed well in an animal model using a reliable and scalable purification platform to eliminate undesirable proteins. The long-term storage stability and portability of hemoglobin (Hb)-based oxygen carriers are important design criteria in the development of these therapeutics for use in emergency medicine in austere environments. Lyophilization or storing proteins in a freeze-dried form is known to increase storage lifetime and reduce overall weight. In Chapter 4, we (open full item for complete abstract)

Committee: Andre Palmer (Advisor); Jeffrey Chalmers (Committee Member); Dana McTigue (Committee Member); Eduardo Reategui (Committee Member); David Wood (Committee Member) Subjects: Biochemistry; Chemical Engineering