Feasibility of pleural and perilesional subcutaneous microdialysis to assess porcine experimental pulmonary contusion

Günther, Mattias; Sondén, Anders; Gustavsson, Jenny; Arborelius, Ulf P.; Rocksén, David

doi:10.1080/01902148.2020.1742252

Cited by 6 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For animals randomized to BABT, a focally severe pulmonary contusion was induced, as previously described 8,9 by a gunshot perpendicular to a body armor panel fixed on the mid-lateral right thorax with two 3-cm wide girdles. The armor protection consisted of a 300 Â 255 mm ceramic ballistic plate (weight 3 Kg) and 14 additional 0.24 mm aramid layers placed behind the plate (Åkers Krutbruk Protection Inc.) (Figure 2).…”

Section: Babtmentioning

confidence: 99%

“…3,[6][7][8] We have described an immediate and severe hypoxia following high velocity projectile BABT in swine. 9 The mechanisms are not sufficiently elucidated. Hypoxia may result from hypoventilation, low inspired air O 2 (PIO 2 ), diffusion limitation, low ventilation-perfusion (V 0 A/Q 0 ) regions or shunt.…”

Section: Introductionmentioning

confidence: 99%

“…We therefore investigated the acute consequences in both lungs separately, and the effects of alveolar recruitment after high velocity projectile BABT caused by NATO-grade 7.62 Â 51 mm bullets with a mean velocity of 803 m/s, impacting a military grade ceramic plate armor. 8,9 Double lumen tracheal tubes were modified for porcine single lung ventilation and provided respiratory dynamics in the left and right lung separately and intermittently for 2 hours. Alveolar recruitment was performed after one hour.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Severe, transient pulmonary ventilation-perfusion mismatch in the lung after porcine high velocity projectile behind armor blunt trauma

Rocksén

Arborelius

Gustavsson

et al. 2020

Experimental Lung Research

Self Cite

View full text Add to dashboard Cite

Background: Behind armor blunt trauma (BABT) is a non-penetrating injury caused by the rapid deformation of body armor, by a projectile, which may in extreme circumstances cause death. Although there is not a high incidence of high energy BABT, the understanding of the mechanisms is still low, in relation to what is needed for safety threshold levels. BABT is also useful as a model for blunt thoracic trauma, with a compressive speed between traffic accidents and blast caused by explosives. High velocity projectile BABT causes severe hypoxia. The mechanisms are not fully known. We investigated the acute pulmonary consequences in the individual lungs, and the effects of alveolar recruitment. Methods: 12 swine (mean weight 62.5 kg) were randomized to groups BABT by 7.62 Â 51 mm NATO-type bullets (mean velocity 803 m/s) to a military grade ceramic plate armor (n ¼ 7) or control (n ¼ 5). Modified double lumen tracheal tubes provided respiratory dynamics in the lungs separately/intermittently for two hours, with alveolar recruitment after one hour. Results: Venous admixture increased 5 min after BABT (p < .05) and correlated with increased cardiac output. Static compliance decreased 5 minutes after BABT (p < .05) and further by recruitment (p < .005). Physiological dead space decreased 5 minutes after BABT (p < .01) and further by recruitment (p < .01), while not in the contralateral lung. V 0 A/Q 0 decreased 5 minutes after BABT (p < .05), also shown in phase III volumetric capnography (p < .05). Most effects regressed after one hour. Conclusions: High velocity projectile BABT caused hypoxia by a severe and transient decrease in V 0 A/Q 0 to <1 and increased venous admixture in the exposed lung. Alveolar recruitment was hemodynamically and respiratory tolerable and increased V 0 A/Q 0 . Body armor development should aim at ameliorating severe pulmonary consequences from high projectile velocities which also needs to include further understanding of how primary and secondary effects are distributed between the lungs.

show abstract

Section: Babtmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Severe, transient pulmonary ventilation-perfusion mismatch in the lung after porcine high velocity projectile behind armor blunt trauma

Rocksén

Arborelius

Gustavsson

et al. 2020

Experimental Lung Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…1,3,5 BABT is well described in gelatin models but the correlation with human physiology is low. 3,[6][7][8] We have shown that high velocity projectile BABT in swine results in an immediate and severe hypoxia, 9 which is attributed to a severe and transient decrease in ventilation perfusion mismatch (V' A/Q') to <1 and increased venous admixture (Q's/Q't) in the exposed lung. 10 BABT injury mechanisms are complex and differ from other types of thoracic trauma, e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The BABT-simulator was validated to inflict similar back-face signature and impression velocity, when fired directly at the naked chest as a high velocity projectile assault rifle 7.62 mm bullet impacting a ceramic plate armor placed on the thorax at 800 m/s. [8][9][10] Using the BABT-simulator, we investigated the relationship between impact parameters (E k ) and immediate and potentially life-threatening pulmonary consequences. Quantitative estimates of the effect of oxygenation and venous admixture (Q's/Q't) on gas exchange was measured in relation to the E k absorbed by the thorax.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary hypoxia and venous admixture correlate linearly to the kinetic energy from porcine high velocity projectile behind armor blunt trauma

Arborelius

Rocksén

Gustavsson

et al. 2021

Experimental Lung Research

Self Cite

View full text Add to dashboard Cite

Purpose. Behind armor blunt trauma (BABT) is a non-penetrating injury caused by the rapid deformation of body armor, by a projectile, which may in extreme circumstances cause death. The understanding of the mechanisms is still low, in relation to what is needed for safety threshold levels. High velocity projectile BABT causes immediate and severe hypoxia by increased venous admixture (Q's/Q't), but it is not known whether the level of hypoxia correlates to the kinetic energy (E k ) of the projectile. Materials and Methods. We constructed a 65 mm BABT-simulator to measure the E k absorbed by the thorax. The simulator was validated to 7.62 mm high velocity BABT (swine with removed organs) for 7.62 mm (n = 7) and 65 mm (n = 12). Physiological measurements during 60 minutes were performed in 40 anesthetized swine in groups control (n = 9), 7.62 mm (n = 7), 65 mm weight variation (n = 24), 65 mm speed variation (n = 12, included in the weight variation group). New calculations were done for a previously studied group of 7.62 mm with backing (n = 9). Results. 65 mm BABT simulation and 7.62 mm BABT had similar back-face signatures (24 mm), and maximum thoracic impression speed (24-34 m/s). Back-face signatures correlated linearly to E k (R 2 =0.20). Rib fractures had a 50% likelihood at back-face signature 23.0 mm (95% CI 18.5 to 29.0 mm, area under ROC curve 0.93). E k correlated linearly to pO 2 (R 2 =0.34, p = 0.0026) and venous admixture (R 2 =0.37, p = 0.0046). The extrapolated E k at 5 minutes for pO 2 =0 kPa was 587 J and for venous admixture = 100% 574 J. Conclusions. Hypoxia and venous admixture correlated linearly to E k , allowing for a calculated predicted lethal E k to ≥574 J, which should be verified in survival studies. Lethality predictions from lung physiology is an alternative to clay impressions and may facilitate the development of ballistic safety equipment and new BABT safety criteria.

show abstract

The anesthesiologist’s guide to swine trauma physiology research: a report of two decades of experience from the experimental traumatology laboratory

Renberg,

Karlsson,

Dahlquist

et al. 2024

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose Swine are one of the major animal species used in translational research, with unique advantages given the similar anatomic and physiologic characteristics as man, but the investigator needs to be familiar with important differences. This article targets clinical anesthesiologists who are proficient in human monitoring. We summarize our experience during the last two decades, with the aim to facilitate for clinical and non-clinical researchers to improve in porcine research. Methods This was a retrospective review of 337 swine with a mean (SD) weight 60 (4.2) kg at the Experimental Traumatology laboratory at Södersjukhuset (Stockholm south general hospital) between 2003 and 2023, including laboratory parameters and six CT-angiography examinations. Results Swine may be ventilated through the snout using a size 2 neonatal mask. Intubate using a 35 cm miller laryngoscope and an intubating introducer. Swine are prone to alveolar atelectasis and often require alveolar recruitment. Insert PA-catheters through a cut-down technique in the internal jugular vein, and catheters in arteries and veins using combined cut-down and Seldinger techniques. Cardiopulmonary resuscitation is possible and lateral chest compressions are most effective. Swine are prone to lethal ventricular arrhythmias, which may be reversed by defibrillation. Most vital parameters are similar to man, with the exception of a higher core temperature, higher buffer bases and increased coagulation. Anesthesia methods are similar to man, but swine require five times the dose of ketamine. Conclusion Swine share anatomical and physiological features with man, which allows for seamless utilization of clinical monitoring equipment, medication, and physiological considerations.

show abstract

Feasibility of pleural and perilesional subcutaneous microdialysis to assess porcine experimental pulmonary contusion

Cited by 6 publications

References 29 publications

Severe, transient pulmonary ventilation-perfusion mismatch in the lung after porcine high velocity projectile behind armor blunt trauma

Severe, transient pulmonary ventilation-perfusion mismatch in the lung after porcine high velocity projectile behind armor blunt trauma

Pulmonary hypoxia and venous admixture correlate linearly to the kinetic energy from porcine high velocity projectile behind armor blunt trauma

The anesthesiologist’s guide to swine trauma physiology research: a report of two decades of experience from the experimental traumatology laboratory

Contact Info

Product

Resources

About