Faculty Collaboration Database

Survival Rates and Biomarkers in a Large Animal Model of Traumatic Brain Injury Combined With Two Different Levels of Blood Loss. Shock 2021 Apr 01;55(4):554-562

Date

09/04/2020

Pubmed ID

32881755

Pubmed Central ID

PMC8112147

DOI

10.1097/SHK.0000000000001653

Scopus ID

2-s2.0-85103227313 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

INTRODUCTION: The pathology resulting from concurrent traumatic brain injury (TBI) and hemorrhagic shock (HS; TBI+HS) are leading causes of mortality and morbidity worldwide following trauma. However, the majority of large animal models of TBI+HS have utilized focal/contusional injuries rather than incorporating the types of brain trauma (closed-head injury caused by dynamic acceleration) that typify human injury.

OBJECTIVE: To examine survival rates and effects on biomarkers from rotational TBI with two levels of HS.

METHODS: Twenty-two sexually mature Yucatan swine (30.39 ± 2.25 kg; 11 females) therefore underwent either Sham trauma procedures (n = 6) or a dynamic acceleration TBI combined with either 55% (n = 8) or 40% (n = 8) blood loss in this serial study.

RESULTS: Survival rates were significantly higher for the TBI+40% (87.5%) relative to TBI+55% (12.5%) cohort, with the majority of TBI+55% animals expiring within 2 h post-trauma from apnea. Blood-based neural biomarkers and immunohistochemistry indicated evidence of diffuse axonal injury (increased NFL/Aβ42), blood-brain barrier breach (increased immunoglobulin G) and inflammation (increased glial fibrillary acidic protein/ionized calcium-binding adaptor molecule 1) in the injured cohorts relative to Shams. Invasive hemodynamic measurements indicated increased shock index and decreased pulse pressure in both injury cohorts, with evidence of partial recovery for invasive hemodynamic measurements in the TBI+40% cohort. Similarly, although both injury groups demonstrated ionic and blood gas abnormalities immediately postinjury, metabolic acidosis continued to increase in the TBI+55% group ∼85 min postinjury. Somewhat surprisingly, both neural and physiological biomarkers showed significant changes within the Sham cohort across the multi-hour experimental procedure, most likely associated with prolonged anesthesia.

CONCLUSION: Current results suggest the TBI+55% model may be more appropriate for severe trauma requiring immediate medical attention/standard fluid resuscitation protocols whereas the TBI+40% model may be useful for studies of prolonged field care.

Author List

Mayer AR, Dodd AB, Ling JM, Stephenson DD, Rannou-Latella JG, Vermillion MS, Mehos CJ, Johnson VE, Gigliotti AP, Dodd RJ, Chaudry IH, Meier TB, Smith DH, Bragin DE, Lai C, Wagner CL, Guedes VA, Gill JM, Kinsler R

Author

Timothy B. Meier PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Animals
Biomarkers
Brain Injuries, Traumatic
Disease Models, Animal
Female
Male
Shock, Hemorrhagic
Survival Rate
Swine