Development of a Large Animal Model for Investigating Resuscitation After Blast and Hemorrhage

Garner, J.; Watts, S.; Parry, C.; Bird, J.; Kirkman, E.
October 2009
World Journal of Surgery;Oct2009, Vol. 33 Issue 10, p2194
Academic Journal
Blast injuries are an increasing problem owing to the widespread terrorist threat, but hemorrhage remains the second leading cause of civilian trauma death. Against this background, increasing numbers of prehospital and military trauma organizations are advocating a hypotensive approach to resuscitation of the hypovolemic casualty, deliberately aiming not to achieve a normal blood pressure so as not to disturb any newly formed blood clots at the site of a vascular injury. There are no data available to guide clinicians as to how best to resuscitate the blast-injured casualty who has also suffered a hemorrhagic injury. A large-scale program was initiated to examine this question and to offer clinical guidance on the optimal resuscitation strategy in such circumstances in terms of volume, type of fluid, speed of resuscitation, and appropriate endpoints. Before such experiments could be undertaken, a novel large animal model of blast and hemorrhage had to be devised and validated. This study outlines the derivation of such a large animal model utilizing terminally anesthetized Large White pigs exposed to a standardized primary blast wave followed by a controlled hemorrhage of 30% of the total blood volume. The preliminary results confirm the reliability and reproducibility of this model.


Related Articles

  • Minimizing Preventable Trauma Deaths in a Limited-Resource Setting: A Test-Case of a Multidisciplinary Panel Review Approach at the Komfo Anokye Teaching Hospital in Ghana. Yeboah, Dominic; Mock, Charles; Karikari, Patrick; Agyei-Baffour, Peter; Donkor, Peter; Ebel, Beth // World Journal of Surgery;Jul2014, Vol. 38 Issue 7, p1707 

    Objective: Our objectives were to determine the proportion of preventable trauma deaths at a large trauma hospital in Kumasi, Ghana, and to identify opportunities for the improvement of trauma care. Methods: A multidisciplinary panel of experts evaluated pre-hospital, hospital, and postmortem...

  • Acute resuscitation of the unstable adult trauma patient: bedside diagnosis and therapy. Kirkpatrick, Andrew W.; Ball, Chad G.; D'Amours, Scott K.; Zygun, David // Canadian Journal of Surgery;Feb2008, Vol. 51 Issue 1, p57 

    Traumatic injury remains the leading cause of potentially preventable death in Canadians under age 40 years. Although only a minority of patients present with hemodynamic instability, these patients have a significant chance of dying. The causes of instability must be recognized and corrected...

  • Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Khan, Sirat; Davenport, Ross; Raza, Imran; Glasgow, Simon; De'Ath, Henry; Johansson, Pär; Curry, Nicola; Stanworth, Simon; Gaarder, Christine; Brohi, Karim // Intensive Care Medicine;Feb2015, Vol. 41 Issue 2, p239 

    Objective: To determine the effectiveness of blood component therapy in the correction of trauma-induced coagulopathy during hemorrhage. Background: Severe hemorrhage remains a leading cause of mortality in trauma. Damage control resuscitation strategies target trauma-induced coagulopathy (TIC)...

  • Critical Care Management of the Patient with Subarachnoid Hemorrhage. Luks, Andrew M. // Critical Care Alert;Nov2008, Vol. 16 Issue 8, p60 

    The article presents a study about managing patient with spontaneous subarachnoid hemorrhage which is associated with high morbidity and mortality.

  • Acute Management of Hemodynamically Unstable Pelvic Trauma Patients: Time for a Change? Multicenter Review of Recent Practice. Verbeek, Diederik; Sugrue, Michael; Balogh, Zsolt; Cass, Danny; Civil, Ian; Harris, Ian; Kossmann, Thomas; Leibman, Steve; Malka, Valerie; Pohl, Anthony; Rao, Sudhakar; Richardson, Martin; Schuetz, Michael; Ursic, Caesar; Wills, Vanessa // World Journal of Surgery;Aug2008, Vol. 32 Issue 8, p1874 

    Hemorrhage-related mortality (HRM) associated with pelvic fractures continues to challenge trauma care. This study describes the management and outcome of hemodynamically unstable patients with a pelvic fracture, with emphasis on primary intervention for hemorrhage control and HRM. Blunt trauma...

  • Life-saving or life-threatening? Prehospital thoracostomy for thoracic trauma. Perkins, Zane; Gunning, Matthew // Emergency Medicine Journal;Apr2007, Vol. 24 Issue 4, p305 

    The article discusses the case of a male patient who underwent prehospital thoracostomy for thoracic trauma. The case demonstrates the importance of advanced chest decompression skills in the prehospital resuscitation of patients with critical trauma. Serious complications associated with chest...

  • Management of traumatic brain injury: some current evidence and applications. Guha, A. // Postgraduate Medical Journal;Nov2004, Vol. 80 Issue 949, p650 

    Traumatic brain injury remains a worldwide problem. Newer modalities in the management of such injuries include both drugs and therapeutic strategies. Continuing research in animal models has provided a better understanding of the pathophysiological processes that follow head injury, and this in...

  • Clinical digest. Researchers assess attitudes to family presence during resuscitation scenarios.  // Nursing Standard;10/17/2012, Vol. 27 Issue 7, p17 

    The article discusses research which was reported in the article "Reactions of Staff Members and Lay People to Family Presence During Resuscitation: The Effect of Visible Bleeding, Resuscitation Outcome and Gender" by M. Itzhaki et al. and found that both medical staff and lay people perceive...

  • Evaluation of the effect of colloid (Haemaccel) on the bleeding time in the trauma patient. Evans, P. A.; Garnett, M.; Boffard, K.; Kirkman, E.; Jacobson, B. F. // Journal of the Royal Society of Medicine;Feb1996, Vol. 89 Issue 2, p101P 

    The article reports on the highlights of the results of a study of the effect of colloid within Haemaccel on the bleeding time in the trauma patient. Haemaccel is commonly used in conjunction with a crystalloid which has been shown to increase its benefits. The article describes the effects of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics