A porcine polytrauma model with two different degrees of hemorrhagic shock: outcome related to trauma within the first 48 h

Eschbach, Daphne-Asimenia; Steinfeldt, Thorsten; Hildebrand, Frank; Frink, Michael; Schöller, Karsten; Sassen, Martin; Wiesmann, Thomas; Debus, Florian; Vogt, Nina; Uhl, Eberhard; Wulf, Hinnerk; Ruchholtz, Steffen; Pape, Hans-Christian; Horst, Klemens

doi:10.1186/s40001-015-0162-0

Cited by 19 publications

(18 citation statements)

References 39 publications

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“…Furthermore, for blunt chest trauma induction a pair of panels (steel: 0.8 cm and lead: 1.0 cm thickness) was placed on the right dorsal, lower chest. The bolt was shot (Blitz-Kerner, turbocut JOBB GmbH, Germany) onto this panel using cattle-killing cartridges (9 × 17; Dynamit Nobel AG, Troisdorf, Germany) simulating blunt lung contusion as previously described7576. The bolt shot was applied while the lungs of the animals were inflated.…”

Section: Methodsmentioning

confidence: 99%

Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

Horst

Simon

Pfeifer

et al. 2016

Sci Rep

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Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock). Additionally, non-injured animals served as sham controls. Chest trauma resulted in severe lung damage on both CT and histological analyses. Furthermore, severe inflammation with a systemic increase of IL-6 (p = 0.0305) and a local increase of IL-8 in BAL (p = 0.0009) was observed. The pO2/FiO2 ratio in trauma animals decreased over the observation period (p < 0.0001) but not in the sham group (p = 0.2967). Electrical Impedance Tomography (EIT) revealed differences between the traumatized and healthy lung (p < 0.0001). In conclusion, a clinically relevant, long-term model of blunt chest trauma with concomitant injuries has been developed. This reproducible model allows to examine local and systemic consequences of trauma and is valid for investigation of potential diagnostic or therapeutic options. In this context, EIT might represent a radiation-free method for bedside diagnostics.

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Section: Methodsmentioning

confidence: 99%

Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

Horst

Simon

Pfeifer

et al. 2016

Sci Rep

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“…According to the above mentioned guidelines all experimental procedures (including catheterization, trauma, hemorrhage, resuscitation, ICU-treatment) were conducted under deep anesthesia and analgesia to minimize animal suffering and distress using propofol 3–4 mg kg/h and sufentanil 0.8 μg/kg/h during the entire study period of 48h. This setting was previously described by Eschbach et al [ 17 ]. Consistent with the described guidelines and the EAST guidelines for resuscitation endpoints, endpoints were defined as earliest indicator in an animal of intractable pain, distress, suffering, or impending death during the study period [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…In the Hypothermia-Trauma group (HT-T, n = 15) the body temperature was lowered to 33°C for 12 h. The sham groups were named Normothermia-sham (NT-S, n = 5) and Hypothermia-sham (HT-S, n = 5). As we acted in line with the accepted principal of the “3 Rs” (restriction, refinement, reduction), we compared the data of hypothermic animals in this study to results of a normothermic cohort gained from an identical experimental setting (NT-T: n = 15; sham: n = 5) [ 8 , 17 ].…”

Section: Methodsmentioning

confidence: 99%

Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model

et al. 2016

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BackgroundHypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma.Materials & MethodsMale pigs (35 ± 5kg) were mechanically ventilated and monitored over the study period of 48 h. Combined trauma included tibia fracture, lung contusion, liver laceration and pressure-controlled hemorrhagic shock (MAP < 30 ± 5 mmHg for 90 min). After resuscitation, hypothermia (33°C) was induced for a period of 12 h (HT-T group) with subsequent re-warming over a period of 10 h. The NT-T group was kept normothermic. Systemic and local (fracture hematoma) cytokine levels (IL-6, -8, -10) and alarmins (HMGB1, HSP70) were measured via ELISA.ResultsSevere signs of shock as well as systemic and local increases of pro-inflammatory mediators were observed in both trauma groups. In general the local increase of pro- and anti-inflammatory mediator levels was significantly higher and prolonged compared to systemic concentrations. Induction of hypothermia resulted in a significantly prolonged elevation of both systemic and local HMGB1 levels at 48 h compared to the NT-T group. Correspondingly, local IL-6 levels demonstrated a significantly prolonged increase in the HT-T group at 48 h.ConclusionA prolonged inflammatory response might reduce the well-described protective effects on organ and immune function observed in the early phase after hypothermia induction. Furthermore, local immune response also seems to be affected. Future studies should aim to investigate the use of therapeutic hypothermia at different degrees and duration of application.

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“…Cattle-killing cartridges (9 × 17; DynamitNobel AG, Troisdorf, Germany) were used. The PT group received blunt chest trauma, induced by a bolt shot fired on a pair of panels that was placed on the right dorsal, lower chest (20,21). Lungs were inflated when the bolt shot was applied.…”

Section: Induction Of Multiple Trauma and Hemorrhagementioning

confidence: 99%

Trauma Severity and Its Impact on Local Inflammation in Extremity Injury—Insights From a Combined Trauma Model in Pigs

et al. 2020

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Background: Extremity fracture is frequently seen in multiple traumatized patients. Local post-traumatic inflammatory reactions as well as local and systemic interactions have been described in previous studies. However, trauma severity and its impact on the local immunologic reaction remains unclear. Therefore, fracture-associated local inflammation was investigated in a porcine model of isolated and combined trauma to gain information about the early inflammatory stages. Material and Methods: Polytrauma (PT) consisted of lung contusion, liver laceration, femur fracture, and controlled hemorrhage. Monotrauma (MT) consisted of femur fracture only. The fracture was operatively stabilized and animals were monitored under ICU-standard for 72 h. Blood, fracture hematoma (FH) as well as muscle samples were collected throughout the experimental period. Levels of local and systemic pro-and anti-inflammatory as well as angiogenetic cytokines were measured by ELISA. Results: Both groups showed a significant decrease in pro-inflammatory IL-6 in FH over time. However, concentrations in MT were significantly higher than in PT. The IL-8 concentrations initially decreased in FH, but recovered by the end of the observation period. These dynamics were only statistically significant in MT. Furthermore, concentrations measured in muscle tissue showed inverse kinetics compared to those in FH. The IL-10 did not present statistical resilient dynamics over time, although a slight increase in FH was seen by the end of the observation time in the MT group. Conclusions: Time-dependent dynamics of the local inflammatory response were observed. Trauma severity showed a significant impact, with lower values in pro-as well as angiogenetic mediators. Fracture repair could be altered by these trauma-related changes of the local immunologic milieu, which might serve as a possible explanation for the higher rates of delayed or non-union bone repair in polytraumatised patients.

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A porcine polytrauma model with two different degrees of hemorrhagic shock: outcome related to trauma within the first 48 h

Cited by 19 publications

References 39 publications

Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model

Trauma Severity and Its Impact on Local Inflammation in Extremity Injury—Insights From a Combined Trauma Model in Pigs

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