title: Combined hemorrhage/trauma models in pigs-current state and future perspectives.
abstract: The majority of injury combinations in multiply injured patients entail the chest, abdomen, and extremities. Numerous pig models focus on the investigation of posttraumatic pathophysiology, organ performance monitoring and on potential treatment options. Depending on the experimental question, previous authors have included isolated insults (controlled or uncontrolled hemorrhage, chest trauma) or a combination of these injuries (hemorrhage with abdominal trauma, chest trauma, traumatic brain injury, and/or long-bone fractures). Combined trauma models in pigs can provide a high level of clinical relevance, when they are properly designed and mimicking the clinical situation. Most of these models focus on the first hours after trauma, to assess the acute sequel of traumatic hemorrhage. However, hemorrhagic shock and the associated mass transfusion are also major causes for organ failure and mortality in the later clinical course. Thus, most models lack information on the pathomechanisms during the late posttraumatic phase. Studying new therapies only during the early phase is also not reflective of the clinical situation. Therefore, a longer observation period is required to study the effects of therapeutic approaches during intensive care treatment when using animal models. These long-term studies of combined trauma models will allow the development of valuable therapeutic approaches relevant for the later posttraumatic course. This review summarizes the existing porcine models and outlines the need for long-term models to provide real effective novel therapeutics for multiply injured patients to improve organ function and clinical outcome.
authors.affiliation: *Department of Orthopedic Trauma, and Harald Tscherne Research Laboratory for Orthopedic Trauma, University of Aachen, Aachen; †Department of Orthopedic Trauma, Hand-, Plastic- and Reconstructive Surgery, University of Ulm, Ulm; and ‡Department of Experimental Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.forename: Hagen
authors.initials: H
authors.lastname: Andruszkow
authors.forename: Markus
authors.initials: M
authors.lastname: Huber-Lang
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
authors.forename: Martijn
authors.initials: M
authors.lastname: van Griensven
mesh_terms: D000007:Abdominal Injuries / Q000503:physiopathology; D000818:Animals; D001930:Brain Injuries / Q000503:physiopathology; D006470:Hemorrhage / Q000503:physiopathology; D023421:Models, Animal; D009102:Multiple Organ Failure / Q000209:etiology*; D009104:Multiple Trauma; D012771:Shock, Hemorrhagic / Q000628:therapy; D013552:Swine; D013898:Thoracic Injuries / Q000503:physiopathology