Development of a lethal, closed-abdomen grade v hepato-portal injury model in non-coagulopathic swine

Michael J. Duggan, Ali Y. Mejaddam, John Beagle, Marc A. Demoya, George C. Velmahosa, Hasan B. Alam, Adam Rago, Greg Zugates, Rany Busold, Toby Freyman, Upma Sharma, David R. King*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

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. Conclusion: This model can be used to screen other interventions for pre hospital control of noncompressible.

Original languageEnglish (US)
Pages (from-to)101-107
Number of pages7
JournalJournal of Surgical Research
Volume182
Issue number1
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Keywords

  • Animal
  • Closed cavity
  • Lethal hemorrhage
  • Liver injury
  • Portal vein injury
  • Resuscitation
  • Swine

ASJC Scopus subject areas

  • Surgery

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