Combined Hemorrhage/Trauma Models in Pigs—Current State and Future Perspectives

Abstract

The majority of injury combinations in multiply injured patients entail the chest, abdomen, and extremities. Numerous pig models focus on the investigation of posttraumatic pathophysiology, organ performance monitoring and on potential treatment options. Depending on the experimental question, previous authors have included isolated insults (controlled or uncontrolled hemorrhage, chest trauma) or a combination of these injuries (hemorrhage with abdominal trauma, chest trauma, traumatic brain injury, and/or long-bone fractures). Combined trauma models in pigs can provide a high level of clinical relevance, when they are properly designed and mimicking the clinical situation. Most of these models focus on the first hours after trauma, to assess the acute sequel of traumatic hemorrhage. However, hemorrhagic shock and the associated mass transfusion are also major causes for organ failure and mortality in the later clinical course. Thus, most models lack information on the pathomechanisms during the late posttraumatic phase. Studying new therapies only during the early phase is also not reflective of the clinical situation. Therefore, a longer observation period is required to study the effects of therapeutic approaches during intensive care treatment when using animal models. These long-term studies of combined trauma models will allow the development of valuable therapeutic approaches relevant for the later posttraumatic course. This review summarizes the existing porcine models and outlines the need for long-term models to provide real effective novel therapeutics for multiply injured patients to improve organ function and clinical outcome.

Review of Animal Models of Comorbidities in Fracture‐Healing Research

“…The “TREAT‐Network” ( Tr anslational Larg e A nimal Research Ne t work) has been founded with the main aim to study pathophysiological changes associated with multiple trauma, surgical treatment strategies and emergency interventions . This network introduced a standardized thoracic trauma in combination with controlled hemorrhage, standardized laparotomy including liver laceration, and additional extremity trauma . This large animal model is reproducible and clinically relevant traumatic insult with controlled hemorrhage.…”

Local Inflammation in Fracture Hematoma: Results from a Combined Trauma Model in Pigs

“…These studies either focused on isolated fractures [ 10 – 13 ] or used small animal models with the well-known limitations of translational significance [ 14 – 16 ]. On the other hand, large animal models were established in order to better mimic the human situation [ 17 , 18 ], as the majority of these models were limited by either focus on isolated fractures, a very short posttraumatic observation period (2–6 h), or the fact that animals were extubated and observed in an awake state, which also does not represent the clinical situation after multiple trauma [ 17 , 18 ].…”

Resuscitation with amiodarone increases survival after hemorrhage and ventricular fibrillation in pigs

“…This, however, does not resemble the clinical situation of most trauma patients 28,29 but may be relevant in anaesthetized patients, who suddenly lose 30% of blood volume and develop CA. We acknowledge that our study may lack the power to detect some additional differences because of a relatively small sample size.…”