title: Hypercoagulability in porcine hemorrhagic shock is present early after trauma and resuscitation.
abstract: BACKGROUND
  The understanding of coagulopathy associated with trauma continues to evolve. Trauma patients are frequently coagulopathic early after injury and become hypercoagulable within days of injury. Thrombelastography (TEG) allows real-time evaluation of the coagulation status of patients. We hypothesized that TEG will identify post-traumatic hypercoagulable state in our porcine model of hemorrhagic shock and resuscitation.
  
  
  METHODS
  Fourteen male Yorkshire pigs were sedated, instrumented, and splenectomized via laparotomy. Eight of these animals underwent a shock protocol consisting of a pulmonary contusion via captive bolt gun, 35% hemorrhage and two liver fractures. Vitals, hemodynamics, physiologic parameters and TEG were measured at baseline, after shock and at intervals after injury thru 72 h post-injury.
  
  
  RESULTS
  Animals undergoing surgery and instrumentation demonstrated the same hypercoagulable patterns as animals that received shock, injury, and resuscitation. In this model, hypercoagulability was present in both groups at 4 h after injury and continued for 72 h post-injury (increased angle and maximum amplitude, P < 0.05, compared to baseline). Statistically significant differences between the groups were noted at both 16 and 48 h post-injury.
  
  
  CONCLUSIONS
  Hypercoagulability is present early after surgical intervention and trauma. This finding has implications for use of deep venous thrombosis (DVT) prophylaxis in trauma patients.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA. beilm001@umn
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Mulier
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Greenberg
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Beilman
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D008297:Male; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000097:blood*; D013552:Swine; D013916:Thrombelastography; D019851:Thrombophilia / Q000209:etiology*; D014947:Wounds and Injuries / Q000097:blood*