Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Abstract

Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma. Twelve pigs (German Landrace) underwent femur fracture, liver laceration, blunt chest trauma, and haemorrhagic shock under standard anaesthesia and intensive care monitoring. Microcirculation data were measured from the vastus lateralis muscle using a combined white light spectrometry and laser spectroscopy system every 15 min during the shock and resuscitation period, and at 24, 48, and 72 h. Oxygen delivery and oxygen consumption were calculated and compared to baseline. The relative haemoglobin, local oxygen consumption, and saturation values in the microcirculation were observed significantly lower during shock, however, no changes in the microcirculatory blood flow and microcirculatory oxygen delivery were observed. After resuscitation, the microcirculatory blood flow and relative haemoglobin increased and remained elevated during the whole observation period (72 h). In this study, we observed changes in microcirculation during the trauma and shock phases. Furthermore, we also measured persistent dysfunction of the microcirculation over the observation period of 3 days after resuscitation and haemorrhagic shock. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1377-1382, 2018.

Differences of liver CT perfusion of blunt trauma treated with therapeutic embolization and observation management

“…In other words, the slight increase of HPI at traumatic parenchyma represented a general perfusion compensation to the liver after a successful hemostasis. This compensatory microcirculation phenomenon has also been reported in a porcine poly-trauma model with hemorrhagic shock 26 . We acknowledge that one of the limitations of this study was a small sample size.…”

Review of Animal Models of Comorbidities in Fracture‐Healing Research

“…After deep hypoperfusion, relevant alterations of local microcirculation appear and persist up to 72 h after trauma. Even after resuscitation animals appear to develop hyperemia in peripheral soft tissues for at least 72 h . Whether these changes have an effect on fracture healing, systemic or local inflammation need to be shown in future studies.…”

“…Those markers are known to predict outcomes after polytrauma . Severe hemorrhagic shock has not only effect on organs, such as lung, liver, kidney, etc., but also on peripheral musculature, peripheral soft‐tissues, and bone . After deep hypoperfusion, relevant alterations of local microcirculation appear and persist up to 72 h after trauma.…”

Estimation of the Influence of Different Methods of Administration of Methylethylpyridinol Hydrochloride (Emoxipin) on Elimination of the Pathology of the Microcirculatory Breed in Traumatic Lesions of Limb Muscles

“…При тяжелых травмах наступают выраженные расстройства в системе кровообращения, особенно -в микроциркуляторном русле. Общепризнано, что нарушения гемомикроциркуляции в органах опорно-двигательного аппарата любой этиологии относятся к важнейшим медико-биологическим и социальным проблемам [4,9,10]. Однако в настоящее время уделяется недостаточно внимания анализу структурной перестройки микроциркуляторного русла мышц в условиях нарушения их функции, возникающих в результате травматических поражений.…”