title: Development of a lethal, closed-abdomen grade V hepato-portal injury model in non-coagulopathic swine.
abstract: BACKGROUND
  Hemorrhage within an intact abdominal cavity remains a leading cause of preventable death on the battlefield. Despite this need, there is no existing closed-cavity animal model to assess new hemostatic agents for the preoperative control of intra-abdominal hemorrhage.
  
  
  METHODS
  We developed a novel, lethal liver injury model in non-coagulopathic swine by strategic placement of two wire loops in the medial liver lobes including the hepatic and portal veins. Distraction resulted in grade V liver laceration with hepato-portal injury, massive bleeding, and severe hypotension. Crystalloid resuscitation was started once mean arterial pressure (MAP) fell below 65 mm Hg. Monitoring continued for up to 180 min.
  
  
  RESULTS
  We demonstrated 90% lethality (9/10) in swine receiving injury and fluid resuscitation, with a mean survival time of 43 min. Previous efforts in our laboratory to develop a consistently lethal swine model of abdominal solid organs, including preemptive anticoagulation, a two-hit injury with controlled hemorrhage prior to liver trauma, and the injury described above without resuscitation, consistently failed to result in lethal injury.
  
  
  CONCLUSIONS
  This model can be used to screen other interventions for pre hospital control of noncompressible.
authors.affiliation: Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Duggan
authors.forename: Ali Y
authors.initials: AY
authors.lastname: Mejaddam
authors.forename: John
authors.initials: J
authors.lastname: Beagle
authors.forename: Marc A
authors.initials: MA
authors.lastname: Demoya
authors.forename: George C
authors.initials: GC
authors.lastname: Velmahosa
authors.forename: Hasan B
authors.initials: HB
authors.lastname: Alam
authors.forename: Adam
authors.initials: A
authors.lastname: Rago
authors.forename: Greg
authors.initials: G
authors.lastname: Zugates
authors.forename: Rany
authors.initials: R
authors.lastname: Busold
authors.forename: Toby
authors.initials: T
authors.lastname: Freyman
authors.forename: Upma
authors.initials: U
authors.lastname: Sharma
authors.forename: David R
authors.initials: DR
authors.lastname: King
mesh_terms: D000818:Animals; D062186:Arterial Pressure / Q000502:physiology; D000077324:Crystalloid Solutions; D004195:Disease Models, Animal; D005440:Fluid Therapy; D006470:Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006489:Hemostatic Techniques; D006503:Hepatic Veins / Q000293:injuries*; D007552:Isotonic Solutions / Q000627:therapeutic use; D008099:Liver / Q000293:injuries*; D011169:Portal Vein / Q000293:injuries*; D015996:Survival Rate; D013552:Swine
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions