title: Rabbit model of uncontrolled hemorrhagic shock and hypotensive resuscitation.
abstract: Clinically relevant animal models capable of simulating traumatic hemorrhagic shock are needed. We developed a hemorrhagic shock model with male New Zealand rabbits (2200-2800 g, 60-70 days old) that simulates the pre-hospital and acute care of a penetrating trauma victim in an urban scenario using current resuscitation strategies. A laparotomy was performed to reproduce tissue trauma and an aortic injury was created using a standardized single puncture to the left side of the infrarenal aorta to induce hemorrhagic shock similar to a penetrating mechanism. A 15-min interval was used to simulate the arrival of pre-hospital care. Fluid resuscitation was then applied using two regimens: normotensive resuscitation to achieve baseline mean arterial blood pressure (MAP, 10 animals) and hypotensive resuscitation at 60% of baseline MAP (10 animals). Another 10 animals were sham operated. The total time of the experiment was 85 min, reproducing scene, transport and emergency room times. Intra-abdominal blood loss was significantly greater in animals that underwent normotensive resuscitation compared to hypotensive resuscitation (17.1 ± 2.0 vs 8.0 ± 1.5 mL/kg). Antithrombin levels decreased significantly in normotensive resuscitated animals compared to baseline (102 ± 2.0 vs 59 ± 4.1%), sham (95 ± 2.8 vs 59 ± 4.1%), and hypotensive resuscitated animals (98 ± 7.8 vs 59 ± 4.1%). Evidence of re-bleeding was also noted in the normotensive resuscitation group. A hypotensive resuscitation regimen resulted in decreased blood loss in a clinically relevant small animal model capable of reproducing hemorrhagic shock caused by a penetrating mechanism.
authors.affiliation: Departamento de Cirurgia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. jbrezende.ufmg@gmail.com
authors.forename: J B
authors.initials: JB
authors.lastname: Rezende-Neto
authors.forename: S B
authors.initials: SB
authors.lastname: Rizoli
authors.forename: M V
authors.initials: MV
authors.lastname: Andrade
authors.forename: T A
authors.initials: TA
authors.lastname: Lisboa
authors.forename: J R
authors.initials: JR
authors.lastname: Cunha-Melo
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000379:methods*; D006400:Hematocrit; D008297:Male; D011817:Rabbits; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000097:blood / Q000209:etiology / Q000628:therapy*; D012774:Shock, Traumatic / Q000097:blood / Q000150:complications / Q000628:therapy*