Cardona Venetia, Dufour-Gaume Frédérique, Montespan Florent, Bordone Audrey, Prat Nicolas J
Département Soutien Médico-Chirurgical Des Forces, Unité Traumatologie de Guerre, Institut de Recherche Biomédicale Des Armées, 1 Place du Général Valérie André, 91220, Brétigny-Sur-Orge, France.
Eur J Trauma Emerg Surg. 2025 May 22;51(1):215. doi: 10.1007/s00068-025-02892-w.
Despite the high incidence of death among cases of hemorrhagic shock associated with polytrauma, few animal models are representative of this combined type of aggression, as most essentially reproduce soft tissue injury. To improve trauma research and its applicability to battlefield situations, appropriate animal models simulating battlefield trauma care must be defined. As anesthesia itself influences physiological and hemodynamic variables, we studied three different types of anesthesia, ketamine-midazolam (KM), isoflurane (ISO), and alfaxalone (ALFA), in a porcine model of combat-related hemorrhagic shock injury.
A total of 19 pigs were randomized to the KM (n = 5), ISO (n = 6), and ALFA (n = 8) groups and subjected to a hemorrhagic shock associated with bilateral femoral fractures and delayed resuscitation.
The combined traumatic insult with severe hemorrhage resulted in characteristic signs of severe shock. The KM and ISO groups were representative of the hemodynamic perturbation of hemorrhagic shock, whereas the ALFA group showed signs of low tolerance, with extreme and persistent tachycardia even after resuscitation.
We concluded that ALFA was not the most suitable anesthetic for our hemodynamically compromised model and that KM or ISO were two relevant anesthesia regiments to study traumatic-hemorrhagic shock in pigs. However, KM was the most clinically relevant to medical practices in prehospital medical care or an austere environment.
尽管与多发伤相关的失血性休克病例死亡率很高，但很少有动物模型能代表这种复合型损伤，因为大多数模型主要再现软组织损伤。为了改进创伤研究及其在战场情况下的适用性，必须定义模拟战场创伤护理的合适动物模型。由于麻醉本身会影响生理和血流动力学变量，我们在猪的战斗相关失血性休克损伤模型中研究了三种不同类型的麻醉，即氯胺酮 - 咪达唑仑（KM）、异氟烷（ISO）和阿法沙龙（ALFA）。
总共19头猪被随机分为KM组（n = 5）、ISO组（n = 6）和ALFA组（n = 8），并遭受与双侧股骨骨折相关的失血性休克和延迟复苏。
严重出血的复合创伤导致了严重休克的典型体征。KM组和ISO组代表了失血性休克的血流动力学扰动，而ALFA组表现出耐受性低的迹象，即使在复苏后仍有极端且持续的心动过速。
我们得出结论，ALFA不是我们血流动力学受损模型最合适的麻醉剂，而KM或ISO是研究猪创伤性失血性休克的两种相关麻醉方案。然而，KM在院前医疗护理或严峻环境中的医疗实践中与临床最为相关。
