Evidence map›Paper›PMID 38780780›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

Development of a two-hit lethal liver injury model in swine.

Emanuele Lagazzi, Helen S Wei, Vahe S Panossian, Jessica B Pallotta, Anet Calisir, Wardah Rafaqat, May Abiad, Ikemsinachi C Nzenwa, David R King, Celestine Hong and 4 more

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Emanuele LagazziDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA. elagazzi@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-5696-9641
Helen S WeiDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Vahe S PanossianDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Jessica B PallottaDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Anet CalisirDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Wardah RafaqatDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.ORCID http://orcid.org/0000-0002-7224-486X
May AbiadDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Ikemsinachi C NzenwaDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
David R KingDivision of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Celestine HongDepartment of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
Paula HammondDepartment of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
Bradley OlsenDepartment of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
Michael J Duggan *Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
George C Velmahos *Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.

Funding

U.S. Army Medical Research Acquisition Activity (USAMRAA) W81XWH-18-2-0010
6 · The paper itself

Abstract

purposeNoncompressible truncal hemorrhage remains a leading cause of preventable death in the prehospital setting. Standardized and reproducible large animal models are essential to test new therapeutic strategies. However, existing injury models vary significantly in consistency and clinical accuracy. This study aims to develop a lethal porcine model to test hemostatic agents targeting noncompressible abdominal hemorrhages.

methodsWe developed a two-hit injury model in Yorkshire swine, consisting of a grade IV liver injury combined with hemodilution. The hemodilution was induced by controlled exsanguination of 30% of the total blood volume and a 3:1 resuscitation with crystalloids. Subsequently, a grade IV liver injury was performed by sharp transection of both median lobes of the liver, resulting in major bleeding and severe hypotension. The abdominal incision was closed within 60 s from the injury. The endpoints included mortality, survival time, serum lab values, and blood loss within the abdomen.

resultsThis model was lethal in all animals (5/5), with a mean survival time of 24.4 ± 3.8 min. The standardized liver resection was uniform at 14.4 ± 2.1% of the total liver weight. Following the injury, the MAP dropped by 27 ± 8mmHg within the first 10 min. The use of a mixed injury model (i.e., open injury, closed hemorrhage) was instrumental in creating a standardized injury while allowing for a clinically significant hemorrhage.

conclusionThis novel highly lethal, consistent, and clinically relevant translational model can be used to test and develop life-saving interventions for massive noncompressible abdominal hemorrhage.

Indexed as

Disease Models, AnimalLiverAbdominal InjuriesAnimalsExsanguinationHemodilutionHemorrhageResuscitationSwineBleedingHemorrhageLiver injuryNon-compressibleSwineTrauma

Identifiers

PMID38780780

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.