Hypercoagulability in porcine hemorrhagic shock is present early after trauma and resuscitation

Kristine E. Mulier, Joseph G. Greenberg, Gregory J. Beilman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Introduction: The understanding of coagulopathy associated with trauma continues to evolve. Trauma patients are frequently coagulopathic early after injury and become hypercoagulable within days of injury. Thrombelastography (TEG) allows real-time evaluation of the coagulation status of patients. We hypothesized that TEG will identify post-traumatic hypercoagulable state in our porcine model of hemorrhagic shock and resuscitation. Methods: Fourteen male Yorkshire pigs were sedated, instrumented, and splenectomized via laparotomy. Eight of these animals underwent a shock protocol consisting of a pulmonary contusion via captive bolt gun, 35% hemorrhage and two liver fractures. Vitals, hemodynamics, physiologic parameters and TEG were measured at baseline, after shock and at intervals after injury thru 72 h post-injury. Results: Animals undergoing surgery and instrumentation demonstrated the same hypercoagulable patterns as animals that received shock, injury, and resuscitation. In this model, hypercoagulability was present in both groups at 4 h after injury and continued for 72 h post-injury (increased angle and maximum amplitude, P < 0.05, compared to baseline). Statistically significant differences between the groups were noted at both 16 and 48 h post-injury. Conclusions: Hypercoagulability is present early after surgical intervention and trauma. This finding has implications for use of deep venous thrombosis (DVT) prophylaxis in trauma patients.

Original languageEnglish (US)
Pages (from-to)e31-e35
JournalJournal of Surgical Research
Volume174
Issue number1
DOIs
StatePublished - May 1 2012

Bibliographical note

Funding Information:
This work is supported by the Office of Naval Research , grant N00014-09-1-0323 and the Defense Advanced Research Projects Agency , grant N6111-03-1-0267 .

Keywords

  • deep venous thrombosis
  • hypercoagulable state
  • thromboelastography
  • trauma

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