• Michael J Duggan, Ali Y Mejaddam, John Beagle, Marc A Demoya, George C Velmahosa, Hasan B Alam, Adam Rago, Greg Zugates, Rany Busold, Toby Freyman, Upma Sharma, and David R King.
• Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA.
• J. Surg. Res. 2013 Jun 1;182(1):101-7.

BackgroundHemorrhage within an intact abdominal cavity remains a leading cause of preventable death on the battlefield. Despite this need, there is no existing closed-cavity animal model to assess new hemostatic agents for the preoperative control of intra-abdominal hemorrhage.MethodsWe developed a novel, lethal liver injury model in non-coagulopathic swine by strategic placement of two wire loops in the medial liver lobes including the hepatic and portal veins. Distraction resulted in grade V liver laceration with hepato-portal injury, massive bleeding, and severe hypotension. Crystalloid resuscitation was started once mean arterial pressure (MAP) fell below 65 mm Hg. Monitoring continued for up to 180 min.ResultsWe demonstrated 90% lethality (9/10) in swine receiving injury and fluid resuscitation, with a mean survival time of 43 min. Previous efforts in our laboratory to develop a consistently lethal swine model of abdominal solid organs, including preemptive anticoagulation, a two-hit injury with controlled hemorrhage prior to liver trauma, and the injury described above without resuscitation, consistently failed to result in lethal injury.ConclusionThis model can be used to screen other interventions for pre hospital control of noncompressible.Copyright © 2013 Elsevier Inc. All rights reserved.

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