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Environmental Hypothermia in Porcine Polytrauma and Hemorrhagic Shock is Safe.
MedLine Citation:
PMID:  22777118     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
MINI-ABSTRACT: In our porcine model of polytrauma and hemorrhagic shock, initial resuscitation couple with targeted hypothermia for 1 hour was not associated with increased morbidity or mortality despite mildly elevated markers of organ injury at 24 hours after injury. STRUCTURED ABSTRACT: OBJECTIVE: We have previously demonstrated survival benefit to induced hypothermia in a porcine model of controlled hemorrhagic shock simulating an associated delay to definitive care. In the current study, we wished to evaluate the effects of environmental hypothermia in a porcine model of hemorrhagic shock with the addition of polytrauma. METHODS: Sixteen pigs were randomized to normothermic (39°C, n=7) or hypothermic (34°C, n=9) groups. The model included instrumentation, chest injury (captive bolt device), hemorrhage to systolic blood pressure (SBP) of ∼50mmHg and crush liver injury. Animals received limited fluid resuscitation for a 1-hour period with goal SBP of >80mmHg and ice packs or warming blankets to achieve goal temperatures, followed by full resuscitation with goal SBP >90mmHg, adequate urine output and hemoglobin by protocol for 20 hours. Survivors were observed for an additional 24 hours with endpoints including mortality, markers of organ injury and neurologic function. RESULTS: There were no differences in survival between the groups (mortality = 1/9, hypothermia group vs 2/7, normothermia group, p=0.39). Markers of organ injury were elevated in the hypothermia group at 24 hours after injury but were identical between groups at the end of the experimental protocol (48 hours after injury). There were no noted differences in neurologic function between the two groups. CONCLUSION: Environmental hypothermia in a model of polytrauma and hemorrhagic shock was not associated with worse outcomes.
Authors:
Uroghupatei P Iyegha; Joseph J Greenberg; Kristine E Mulier; Jeffrey Chipman; Mark George; Greg J Beilman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-6
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Department of Surgery, University of Minnesota, Minneapolis, MN.
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