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

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:104

Review

Mayer, Andrew R.^1,2,3,4  Dodd, Andrew B.¹  Vermillion, Meghan S.¹  Stephenson, David D.¹  Chaudry, Irshad H.⁵  Bragin, Denis E.⁶  Gigliotti, Andrew P.¹  Dodd, Rebecca J.¹  Wasserott, Benjamin C.¹  Shukla, Priyank¹  Kinsler, Rachel⁷  Alonzo, Sheila M.¹ 

[1] Lovelace Biomed & Environm Res Inst, Mind Res Network, Pete & Nancy Domenici Hall,1011 Yale Blvd NE, Albuquerque, NM 87106 USA

[2] Univ New Mexico, Sch Med, Neurol Dept, Albuquerque, NM 87131 USA

[3] Univ New Mexico, Sch Med, Psychiat Dept, Albuquerque, NM 87131 USA

[4] Univ New Mexico, Psychol Dept, Albuquerque, NM 87131 USA

[5] Univ Alabama Birmingham, Dept Surg, Birmingham, AL 35294 USA

[6] Univ New Mexico, Sch Med, Dept Neurosurg, Albuquerque, NM 87131 USA

[7] US Army, Dept Army Civilian, Aeromed Res Lab, Ft Rucker, AL 36362 USA

关键词: Hypovolemia;    Shock;    Traumatic brain injury;    Poly-neurotrauma;    Large animal models;    Common data elements;   

DOI  :  10.1016/j.neubiorev.2019.06.024

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

Free