A porcine polytrauma model with two different degrees of hemorrhagic shock: outcome related to trauma within the first 48 h.
BACKGROUND
An animal polytrauma model was developed, including trunk and extremity injuries combined with hemorrhagic shock and a prolonged post-traumatic phase. This could be useful for the assessment of different therapeutic approaches during intensive care therapy.


METHODS
A standardized polytrauma including lung contusion, liver laceration and lower leg fracture was applied in 25 pigs. They underwent controlled haemorrhage either with a blood volume loss of 45 % and a median arterial pressure (MAP) <30 mmHg/90 min (group L, n = 15) or a 50 % blood loss of and an MAP <25 mmHg/120 min (group H, n = 10). Five non-traumatized pigs served as a control (group C). Subsequently, intensive care treatment was given for an observational period of 48 h.


RESULTS
Both trauma groups showed signs of shock and organ injury (heart rate, MAP and lactate). The frequency of cardiopulmonary resuscitation (CPR) and lung injury was directly related to the severity of the haemorrhagic shock (CPR-group L: 4 of 15 pigs, group H: 4 of 10 pigs; Respiratory failure-group L: 3 of 13, group H: 3 of 9. There was no difference in mortality between trauma groups.


CONCLUSIONS
The present data suggest that our model reflects the mortality and organ failure of polytrauma in humans during shock and the intensive care period. This suggests that the experimental protocol could be useful for the assessment of therapeutic approaches during the post-traumatic period.
Center for Orthopaedics and Trauma Surgery; University Hospital Giessen and Marburg, Marburg, Germany. eschbach@med.uni-marburg.de.
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Eschbach
Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany. steinfel@med.uni-marburg.de.
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T
Steinfeldt
Trauma Department, University of Aachen, Aachen, Germany. fhildebrand@ukaachen.de.
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F
Hildebrand
Center for Orthopaedics and Trauma Surgery; University Hospital Giessen and Marburg, Marburg, Germany. frink@med.uni-marburg.de.
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M
Frink
Department of Neurosurgery, University of Giessen, Giessen, Germany. karsten.schoeller@neuro.med.uni-giessen.de.
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K
Schöller
Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany. sassen@med.uni-marburg.de.
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M
Sassen
Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany. thomas.wiesmann@med.uni-marburg.de.
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Wiesmann
Center for Orthopaedics and Trauma Surgery; University Hospital Giessen and Marburg, Marburg, Germany. debusfl@med.uni-marburg.de.
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F
Debus
Department of Neurosurgery, University of Giessen, Giessen, Germany. Nina.K.Vogt@neuro.med.uni-giessen.de.
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N
Vogt
Department of Neurosurgery, University of Giessen, Giessen, Germany. eberhard.uhl@neuro.med.uni-giessen.de.
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E
Uhl
Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany. h.wulf@med.uni-marburg.de.
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H
Wulf
Center for Orthopaedics and Trauma Surgery; University Hospital Giessen and Marburg, Marburg, Germany. ruchholt@med.uni-marburg.de.
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Ruchholtz
Trauma Department, University of Aachen, Aachen, Germany. hpape@ukaachen.de.
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HC
Pape
Trauma Department, University of Aachen, Aachen, Germany. khorst@ukaachen.de.
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Horst
D000818:Animals; D004195:Disease Models, Animal; D055370:Lung Injury / Q000150:complications*; D009104:Multiple Trauma / Q000150:complications*; D012771:Shock, Hemorrhagic / Q000209:etiology*; D013552:Swine