The influence of hypotensive resuscitation in hemorrhagic shock with coexisting severe head injury: an experimental protocol

Vrettos, Theofanis; Athanasopoulos, P.; Karageorgos, Nikolaos; Balasis, Stavros; Gatzounis, George; Siklis, T; Filos, Kriton S.

doi:10.1186/cc5516

Cited by 2 publications

(3 citation statements)

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“…74 To investigate the effects of TBI and hemorrhage on coagulation and complement systems, several studies have used combined models, which produced a hypocoagulable state with reduced clot strength and thrombocytopenia. 18 19 74 75 76 77 78 79 80 The fluid percussion (employs a swift fluid injection to damage the dura), 77 80 controlled cortical impact (using an electromagnetic device for brain penetration), 18 19 74 75 79 rotational acceleration head injury (utilizing a pneumatic device), 78 and blast injury models 76 are fundamental models in TBI research. Each model offers unique insights into different forms of brain injury, furthering our understanding of injury impacts and potential treatment efficacy.…”

Section: Resultsmentioning

confidence: 99%

“…80 Permissive hypotension has also been observed to enhance survival, hemodynamics, and the restoration of cerebral oxygenation in severe head injuries. 77 While previous large animal models of TBI and hemorrhagic shock have primarily used controlled blood loss models that did not fully simulate diffuse injuries following rapid cranium acceleration or deceleration, recent studies with a closed-head, dynamic acceleration model have revealed diverse survival rates associated with varying levels of controlled blood loss. 78…”

Section: Resultsmentioning

confidence: 99%

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The Use of Large Animal Models in Trauma and Bleeding Studies

Rayatdoost,

Grottke

2023

Hamostaseologie

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Background Major trauma often results in significant bleeding and coagulopathy, posing a substantial clinical burden. To understand the underlying pathophysiology and to refine clinical strategies to overcome coagulopathy, preclinical large animal models are often used. This review scrutinizes the clinical relevance of large animal models in hemostasis research, emphasizing challenges in translating findings into clinical therapies. Methods We conducted a thorough search of PubMed and EMBASE databases from January 1, 2010, to December 31, 2022. We used specific keywords and inclusion/exclusion criteria centered on large animal models. Results Our review analyzed 84 pertinent articles, including four animal species: pigs, sheep, dogs, and nonhuman primates (NHPs). Eighty-five percent of the studies predominantly utilized porcine models. Meanwhile, sheep and dogs were less represented, making up only 2.5% of the total studies. Models with NHP were 10%. The most frequently used trauma models involved a combination of liver injury and femur fractures (eight studies), arterial hemorrhage (seven studies), and a combination of hemodilution and liver injury (seven studies). A wide array of coagulation parameters were employed to assess the efficacy of interventions in hemostasis and bleeding control. Conclusions Recognizing the diverse strengths and weaknesses of large animal models is critical for trauma and hemorrhage research. Each model is unique and should be chosen based on how well it aligns with the specific scientific objectives of the study. By strategically considering each model's advantages and limitations, we can enhance our understanding of trauma and hemorrhage pathophysiology and further advance the development of effective treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Use of Large Animal Models in Trauma and Bleeding Studies

Rayatdoost,

Grottke

2023

Hamostaseologie

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“…Functional liver disorders play a special role in case of associated injury concerning development of systemic changes in the body. It is stipulated by the fact that one of the causing agents of associated injury and ischemic-reperfusion syndrome is toxemia, and the liver experiences a greater part of stress performing detoxification function in particular [2,5,6]. Meanwhile, investigations studying the effect of ischemic-reperfusion syndrome on the liver function, and development of cytolytic syndrome with closed abdominal injury complicated by hypovolemic shock in particular are not sufficient.…”

Section: Introductionmentioning

confidence: 99%

Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

Kuzminskyi¹,

Grodetskyi

Thymbalyuk

2021

J Educ Health Sport

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The function of the organs responsible for detoxification processes, in particular the liver, deserves a special role in the conditions of combined trauma. It is proved that ischemia-reperfusion of the limb caused by the imposition of a tourniquet, is the cause of significant toxemia. Under such conditions, it becomes clear that the detoxification function may be impaired, especially against the background of blunt combined trauma to the abdominal organs complicated by massive bleeding. Changes in the detoxification function of the liver are indicated by markers of the cytolytic syndrome. However, there is no clear understanding of how ischemia - limb reperfusion affects the development of cytolytic syndrome.Objective of research: to study the effect of massive blood loss associated with ischemia-reperfusion of the limb on the cytolytic syndrome indicators in case of injury of the abdominal organs. Materials and methods. 100 mature albino male Wistar rats with the body weight of 190-220 grams kept on standard vivarium forage were used in the experiment. The animals were divided into the control and 3 research groups (containing 10 animals each). Arresting bleeding tourniquet was applied proximally on the lower limbs of rats from the first research group for 120 minutes under thiopental-sodium anesthesia (40 mg/kg-1), which caused development of ischemic-reperfusion. Closed abdominal injury was simulated by means of delivering two dosed blows in the region of the abdominal cavity in the second research group; massive blood loss was simulated by means of cutting the femoral vessels and bloodletting from 25 to 30 % of the circulating blood volume in the group. Injuries from the first two groups were combined in the third group. The control group of animals received anesthesia without formation of any injuries. With the aim to determine alterations of cytolytic syndrome the activity of enzymes – markers of cytolytic syndrome ALT and AST were determined by means of a unified method. The animals of the research groups were removed from the experiment under thiopental-sodium anesthesia by means of the total bloodletting from the heart.Results. Analysis of the results of the study found that cytolytic syndrome develops irrespective of the kind of injuries simulated. Thus, even during a day of post-traumatic period ALT and AST activity increases which is clearly registered in all the three research groups. Further destruction of cellular membranes increases till the 3rd day, which is manifested by a considerable increase of ALT and AST activity in the blood serum. This process continues till the 7th day. A tendency to ALT and AST decrease is observed only in the 1st group on the 7th day. Comparison of the 2nd and 3rd research groups within the time interval enables to understand that application of tourniquets on the limbs of animals with closed abdominal injury and massive bleeding deteriorates cytolytic processes.Conclusions: Simulated injuries in the research groups were associated with the occurrence of cytolytic processes possessing a tendency to develop in the period of early signs of traumatic disease. Ischemic-reperfusion syndrome of the limbs accelerates considerably the development of systemic changes with abdominal injuries and hypovolemic shock, which was manifested by a considerable increase of ALT and AST parameters in the group with abdominal trauma and massive blood loss and becoming higher than that of the control in end of the experiment.

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The influence of hypotensive resuscitation in hemorrhagic shock with coexisting severe head injury: an experimental protocol

Cited by 2 publications

References 0 publications

The Use of Large Animal Models in Trauma and Bleeding Studies

The Use of Large Animal Models in Trauma and Bleeding Studies

Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

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