A laparoscopic swine model of noncompressible torso hemorrhage

James Ross, Christopher J. Burns, Eileen M. Sagini, Lee Ann Zarzabal, Jonathan J. Morrison

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Hemorrhage persists as the leading cause of potentially preventable civilian and military death. Noncompressible torso hemorrhage (NCTH) is a particularly lethal injury complex, with few contemporary prehospital interventions available. Various porcine models of hemorrhage have been developed for civilian and military trauma research. However, the predominant contemporary models lack key physiologic characteristics including the natural tamponade provided by an intact abdominal wall.To improve physiologic and clinical relevance, we developed a laparoscopic model of NCTH. This approach maintains both the integrity of the peritoneum and the natural tamponade effect of an intact abdominal wall while preserving the intrinsic physiologic responses to hemorrhage. Furthermore, we present data quantifying the contribution of the swine contractile spleen in the context of uncontrolled hemorrhage. METHODS: Anesthetized adult male Yorkshire swine underwent a laparoscopic Grade V liver injury, with or without open preinjury splenectomy. Animals were observed without intervention for a total of 120 minutes after injury to simulate point of injury, transport time, and arrival at hospital. RESULTS: Shed blood-to-body weight ratio did not differ among groups; however, mortality was higher in splenectomized animals (67% vs. 33%). Cox regression modeling demonstrated a critical time point of 45 minutes and blood pressure as significant predictors of mortality. CONCLUSION: This study describes a model of NCTH that reflects clinically relevant physiology in trauma and uncontrolled hemorrhage. In addition, it quantitatively assesses the role of the swine contractile spleen in the described model.

Original languageEnglish (US)
JournalJournal of Trauma and Acute Care Surgery
Volume77
Issue number3 SUPPL. 2
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Torso
Swine
Hemorrhage
Wounds and Injuries
Abdominal Wall
Spleen
Mortality
Peritoneum
Splenectomy
Body Weight
Blood Pressure
Liver

Keywords

  • Noncompressible torso hemorrhage
  • splenectomy
  • swine

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery
  • Medicine(all)

Cite this

A laparoscopic swine model of noncompressible torso hemorrhage. / Ross, James; Burns, Christopher J.; Sagini, Eileen M.; Zarzabal, Lee Ann; Morrison, Jonathan J.

In: Journal of Trauma and Acute Care Surgery, Vol. 77, No. 3 SUPPL. 2, 2014.

Research output: Contribution to journalArticle

Ross, James ; Burns, Christopher J. ; Sagini, Eileen M. ; Zarzabal, Lee Ann ; Morrison, Jonathan J. / A laparoscopic swine model of noncompressible torso hemorrhage. In: Journal of Trauma and Acute Care Surgery. 2014 ; Vol. 77, No. 3 SUPPL. 2.
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