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A systematic review of large animal models of combined traumatic brain injury and hemorrhagic shock.


ABSTRACT: Traumatic brain injury (TBI) and severe blood loss (SBL) frequently co-occur in human trauma, resulting in high levels of mortality and morbidity. Importantly, each of the individual post-injury cascades is characterized by complex and potentially opposing pathophysiological responses, complicating optimal resuscitation and therapeutic approaches. Large animal models of poly-neurotrauma closely mimic human physiology, but a systematic literature review of published models has been lacking. The current review suggests a relative paucity of large animal poly-neurotrauma studies (N?=?52), with meta-statistics revealing trends for animal species (exclusively swine), characteristics (use of single biological sex, use of juveniles) and TBI models. Although most studies have targeted blood loss volumes of 35-45%, the associated mortality rates are much lower relative to Class III/IV human trauma. This discrepancy may result from potentially mitigating experimental factors (e.g., mechanical ventilation prior to or during injury, pausing/resuming blood loss based on physiological parameters, administration of small volume fluid resuscitation) that are rarely associated with human trauma, highlighting the need for additional work in this area.

SUBMITTER: Mayer AR 

PROVIDER: S-EPMC7307133 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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A systematic review of large animal models of combined traumatic brain injury and hemorrhagic shock.

Mayer Andrew R AR   Dodd Andrew B AB   Vermillion Meghan S MS   Stephenson David D DD   Chaudry Irshad H IH   Bragin Denis E DE   Gigliotti Andrew P AP   Dodd Rebecca J RJ   Wasserott Benjamin C BC   Shukla Priyank P   Kinsler Rachel R   Alonzo Sheila M SM  

Neuroscience and biobehavioral reviews 20190627


Traumatic brain injury (TBI) and severe blood loss (SBL) frequently co-occur in human trauma, resulting in high levels of mortality and morbidity. Importantly, each of the individual post-injury cascades is characterized by complex and potentially opposing pathophysiological responses, complicating optimal resuscitation and therapeutic approaches. Large animal models of poly-neurotrauma closely mimic human physiology, but a systematic literature review of published models has been lacking. The c  ...[more]

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