The Effect of Hypotensive Resuscitation and Fluid Type on Mortality, Bleeding, Coagulation, & Dysfunctional Inflammation in a Swine Grade V Liver Injury Model
Annual rept. 8 Dec 2005-7 Dec 2006
OREGON HEALTH AND SCIENCES UNIV PORTLAND
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Objectives To determine the optimal fluid resuscitation and anesthetic regimen for swine undergoing uncontrolled hemorrhage. To develop a severe multi-system trauma model resulting in the lethal triad. Methods 1. 20 swine underwent Grade V liver injury followed by 30 minutes of hemorrhagic shock without resuscitation. Hemodynamics were measured using PICCO 2. Systemic and local lung inflammation was measured in animals undergoing TIVA and isoflurane anesthetic. 3. Femur fracture controlled hemorrhage hypothermia and liver injury were combined to create a reproducible model replicating the lethal triad. Results 1. Resuscitation with NS results in decreased SVR and increased CO as well as increased extravascular lung water. This suggests that NS is more likely to predispose trauma patients to ARDS. 2. A systemic pro- inflammatory response can be measured within 2 hours of injury and shock. Anesthesia with TIVA produces suppression of TN F-alpha mRNA in the lung compared to anesthesia with isoflurane. 3. A severe reproducible multi-system injury can be created in swine with good short term survivability. This injury model can be reliably reproduced at multiple distant centers.
- Medicine and Medical Research