Silbergleit R, Satz W, McNamara R M, Lee D C, Schoffstall J M
Medical College of Pennsylvania, Philadelpha, USA.
Acad Emerg Med. 1996 Oct;3(10):917-21. doi: 10.1111/j.1553-2712.1996.tb03319.x.
To compare hemodynamics, mortality rates, and bleeding rates at 3 severities of hemorrhage in a new model of uncontrolled intra-abdominal bleeding that uses an injury of varying severity and geometry unfavorable to thrombosis.
Ten swine were bled through a flow-monitored shunt placed between the femoral artery and the peritoneal cavity. The shunt was connected to catheters of varying diameters placed in the femoral artery to create 3 rates of hemorrhage. Blood flow through the shunt was measured with an in-line Doppler probe. Arterial pressures, cardiac output (CO), and ECGs were monitored. Survival and blood loss were calculated.
The model successfully produced 3 hemorrhage severities. At all 3 rates of bleeding, blood flow was linearly related to mean arterial pressure, with R2 > 0.72. Bleeding was continuous in all groups. The mean numbers of minutes until death were 53, 45, and 25, respectively, at the increasing shock severities. Blood pressure (BP) and CO decreased continuously in all groups, but did so more rapidly with increasing severity of hemorrhage.
In this model of uncontrolled hemorrhage, bleeding was continuous and linearly related to BP. The hemodynamic response to uncontrolled bleeding in this model differs markedly from those in previous wire aortotomy models where wound geometry is favorable to thrombosis. Hence, when injury geometry is favorable to thrombosis (as in aortotomy), thrombosis formation affects hemorrhage rates and hemodynamic responses.
在一种新型的非控制性腹腔内出血模型中，比较三种出血严重程度下的血流动力学、死亡率和出血率，该模型采用了不同严重程度和不利于血栓形成的几何形状的损伤。
十头猪通过置于股动脉和腹腔之间的流量监测分流器进行放血。分流器连接到置于股动脉的不同直径的导管上，以产生三种出血速率。通过在线多普勒探头测量通过分流器的血流量。监测动脉压、心输出量（CO）和心电图。计算生存率和失血量。
该模型成功产生了三种出血严重程度。在所有三种出血速率下，血流量与平均动脉压呈线性相关，R2>0.72。所有组的出血均持续。随着休克严重程度增加，直至死亡的平均分钟数分别为53、45和25。所有组的血压（BP）和CO均持续下降，但随着出血严重程度的增加下降得更快。
在这种非控制性出血模型中，出血持续且与BP呈线性相关。该模型中对非控制性出血的血流动力学反应与先前伤口几何形状有利于血栓形成的主动脉切开术模型中的反应明显不同。因此，当损伤几何形状有利于血栓形成时（如在主动脉切开术中），血栓形成会影响出血速率和血流动力学反应。
