Induced hypothermia does not impair coagulation system in a swine multiple trauma model

Mohr, Juliane; Ruchholtz, Steffen; Hildebrand, Frank; Flohé, Sascha; Frink, Michael; Witte, Ingo; Weuster, Matthias; Fröhlich, Matthias; Griensven, Martijn van; Keibl, Claudia; Mommsen, Philipp

doi:10.1097/ta.0b013e3182826edd

Cited by 50 publications

(47 citation statements)

References 32 publications

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“…Patients at a greater risk of chilling include the elderly, who have a reduced capacity to shiver; young children, who have a large skin surface area in relation to their body weight; people under the influence of alcohol or drugs; people being treated with, for example, β-blockers or antidepressants; and people who have suffered trauma [12]. Chilling and hypothermia affects the body’s coagulation system, so patients bleed more [13,14] and this can, therefore, be lethal in connection with trauma [15]. Drugs or alcohol can contribute to chilling due to physiological causes or due to a deterioration in judgement [16].…”

Section: Introductionmentioning

confidence: 99%

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

Aléx

Uppstu

Saveman

2017

International Journal of Circumpolar Health

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The purpose of the study was to describe the opinions of ambulance personnel regarding differences between using a heated mattress and a standard ambulance mattress. This study was an intervention study with pre- and post-evaluation. Evaluations of the opinions of personnel regarding the standard unheated mattress were conducted initially. After the intervention with new heated mattresses, follow-up evaluations were conducted. Ambulance personnel (n=64) from an ambulance station in northern Sweden took part in the study, which ran from October 2014 until February 2016. There were differences in opinions regarding the standard unheated mattress and the new heated mattress. The evaluation of the proxy ratings by the personnel showed that the heated mattress was warmer than the standard mattress, more pleasant to lie on and that patients were happier and more relaxed than when the standard mattress was used. The ambulance personnel in this study rated the experience of working with the heated mattress as very positive and proxy rated that it had a good effect on patient comfort. A heated mattress can be recommended for patients in ambulance care, even if more research is needed to receive sufficient evidence.

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Section: Introductionmentioning

confidence: 99%

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

Aléx

Uppstu

Saveman

2017

International Journal of Circumpolar Health

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“…However only 3 models have evaluated aspects of the proposed pathophysiologic mechanisms, and as a result animal models are yet to significantly contribute to the improved mechanistic understanding of ATC (40,177,178).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of these models have provided information on the presence and time course of coagulopathy in response to trauma and hemorrhage (29,65,67,177,200,201).…”

Section: Discussionmentioning

confidence: 99%

“…One porcine model demonstrated a brief hypercoaguable response that was followed by significantly reduced viscoelastic function and a 20% prolongation of INR, although a 25% mortality rate was evident within the experimental group (67). A second porcine model demonstrated altered platelet function and prolonged PT that was exacerbated by fluid resuscitation but unaltered by induced hypothermia, although the initial prolongation in PT failed to attain the current clinical definition of ATC (177). Nonsignificant changes in PT or INR were evident in the remaining 5 porcine models (51,(200)(201)(202)(203), although a significant reduction in ROTEM mean clot firmness was evident in one study (203) and significant changes developed following fluid resuscitation and/or the induction of hypothermia and acidosis in the remaining three studies (51,201,202).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…porcine models with varying effects on coagulation function observed (29, 40,51,65,67,177,[200][201][202][203]. All rodent models demonstrated a minimum 20% prolongation in PT, aPTT or PT ratio (PTr) (29, 40, 65) which was attenuated by monoclonal antibodies to aPC in one study (40).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Validation of acute traumatic coagulopathy in an ovine model of trauma and haemorrhage

Zyl¹

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This thesis describes an ovine model of complex trauma and haemorrhage that demonstrates coagulation changes using both traditional plasma based assays and point of care viscoelastic assays that are consistent with current definitions of ATC. The degree of coagulopathy was correlated with the degree of shock as quantified by arterial lactate.Coagulopathy was also associated with activation of the protein C pathway and shedding of the endothelial glycocalyx. Fibrinolysis did not make a significant contribution to the coagulopathy observed and there was no evidence of altered platelet function in this model.ii

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Review of Animal Models of Comorbidities in Fracture‐Healing Research

Haffner‐Luntzer¹,

Hankenson

Ignatius³

et al. 2019

Journal Orthopaedic Research

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There is clinical evidence that patient-specific comorbidities like osteoporosis, concomitant tissue injury, and ischemia may strongly interfere with bone regeneration. However, underlying mechanisms are still unclear. To study these mechanisms in detail, appropriate animal models are needed. For decades, bone healing has been studied in large animals, including dogs, rabbits, pigs, or sheep. However, large animal models display a limited ability to study molecular pathways and cellular functions. Therefore in recent years, mice and rats have become increasingly popular as a model organism for fracture healing research due to the availability of molecular analysis tools and transgenic models. Both large and small animals can be used to study comorbidities and risk factors, modelling the human clinical situation. However, attention has to be paid when choosing an appropriate model due to species differences between large animals, rodents, and humans. This review focuses on large and small animal models for the common comorbidities ischemic injury/reduced vascularization, osteoporosis, and polytrauma, and critically discusses the translational and molecular aspects of these models. Here, we review material which was presented at the workshop "Animal

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Induced hypothermia does not impair coagulation system in a swine multiple trauma model

Cited by 50 publications

References 32 publications

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

Validation of acute traumatic coagulopathy in an ovine model of trauma and haemorrhage

Review of Animal Models of Comorbidities in Fracture‐Healing Research

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