Early changes of coagulation function in a swine traumatic model within 1 hour after traumatic hemorrhagic shock induced by Gunshot injury / 解放军医学杂志

ABSTRACT

Objective To explore the potential mechanism of traumatic coagulopathy through investigating the periodic change of hemodynamics, acid-base system, and coagulation system within 1 hour after traumatic hemorrhagic shock. Methods Adult healthy Landrace pigs were anesthetized to establish a model of hemorrhagic shock-induced by gunshot wounds. Vital signs, Hemodynamic parameters were monitored, and arterial blood gas, routine coagulation as well as thromboelastogram were tested at 15 minutes before the injury, shock point, 10 minutes after the shock, 30 minutes after the shock, and 1 hour after the shock, respectively. Results Among the 16 Landrace pigs that were examined, the mean total blood loss was (1444.22±205.50) ml with a 1-hour survival rate of 68.75%. Among the 11 pigs which survived over 1 hour, Hemodynamic and arterial blood gas analysis showed characteristics of stages. Analysis coagulation test showed that R value, PT and APTT are periodically decreased. The MA value decreased significantly from injury to 10 minutes after shock point (P<0.05), and LY30 showed a significant decreased from 10 minutes aftershock to 1-hour aftershock (P=0.038). In the correlation analysis of coagulation changes, there was a correlation between APTT value and heart rate, diastolic blood pressure, systolic blood pressure, MAP (P<0.05); R value was related to heart rate, SVI, systolic blood pressure, and MAP (P<0.05); MA value was related to BE, LAC, K+, PH, Ca2+, and SVI (P<0.05). Conclusion Within 1 hour after severe traumatic hemorrhagic shock, the coagulation system is in a hypercoagulable state. At 10 minutes after the shock, the fibrinolytic system is inhibited and the fibrinolysis is shut down, which may further aggravate the hypercoagulable state.