The Effect of Hypotensive Resuscitation and Fluid Type on Mortality, Bleeding, Coagulation and Dysfunctional Inflammation in a Swine Grade V Liver Injury Model
Abstract
To determine the optimal fluid resuscitation and anesthetic regimen for swine undergoing uncontrolled hemorrhage. Methods: 1. 37 swine at 3 institutions underwent femur fracture, controlled hemorrhage, hypothermia and resuscitation with normal saline and Grade V liver injury followed by 30 minutes of hemorrhagic shock without resuscitation. Animals were then randomized to controls, shams, whole blood, 1:1 PRBC:FFP, FFP alone and Hextend. Physiologic measurements and coagulation assays were compared between the 3 institutions. 2. 40 swine were randomized to receive midazolam and buprenorphine with either 1-3% isoflurane or IV ketamine (TIVA). Animals underwent a Grade V liver injury followed by 30 minutes of uncontrolled hemorrhagic shock and LR resuscitation to achieve and maintain a MAP of 65mmHg. Physiologic and inflammatory parameters were compared between groups. Results: 1. There was excellent reproducibility in all parameters measured between the 3 centers. Resuscitation with 1:1 FFP:PRBCs and whole blood resulted in significantly lower end of study lactate levels. End of study coagulation parameters were similar in all groups except the Hextend group which was significantly more coagulopathic than the other groups. 2. Mortality was significantly higher in animals receiving TIVA. Dysfunctional inflammation was significantly greater in animals receiving TIVA.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2008
- Accession Number
- ADA487524
Entities
People
- Martin A. Schreiber
Organizations
- Oregon Health & Science University