The swine as a vehicle for research in trauma induced coagulopathy: introducing Principal Component Analysis for viscoelastic coagulation tests
Abstract
BACKGROUND
Uncontrolled bleeding is the leading cause of potentially preventable deaths among trauma patients. Tissue injury and shock result in trauma-induced coagulopathy (TIC). There are still uncertainties regarding detection methods and best practice management for TIC, and a deeper understanding of the pathophysiology requires robust animal models. The applicability of swine in coagulation studies, particularly after trauma has not been sufficiently elucidated. We therefore evaluated the swine as a vehicle for TIC-research in a selection of trauma modalities.
METHODS
26 landrace swine (3 females/23 males) (mean weight 60.0 kg) were anesthetized and randomized to negative controls, receiving no manipulation (n=5), positive controls by hemodilution (n=5), pulmonary contusion without hemorrhage (n=5), pulmonary contusion with hemorrhage (n=5) and blast polytrauma with hypothermia, hypoperfusion, hypoventilation and systemic inflammation (n=6). A comprehensive coagulation panel was analyzed at baseline, 20 min and 120 min after trauma.
RESULTS
PT(INR), aPTT, thrombocytes and fibrinogen did not change after trauma. D-dimer increased (p<.0001), prothrombin decreased (p<.05) and aPC decreased (p<.01) after polytrauma. PAI-1 decreased after pulmonary contusion with hemorrhage (p<.05). Positive controls displayed changes in PT(INR), thrombocytes, fibrinogen, prothrombin, aPC (p<.05). Principal Component Analysis of ROTEM presented pathologic coagulation profiles in both…
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