Resuscitation with whole blood or blood components improves survival and lessens the pathophysiological burden of trauma and haemorrhagic shock in a pre-clinical porcine model.

PURPOSE: In military trauma, disaster medicine, and casualties injured in remote locations, times to advanced medical and surgical treatment are often prolonged, potentially reducing survival and increasing morbidity. Since resuscitation with blood/blood components improves survival over short pre-surgical times, this study aimed to evaluate the quality of resuscitation afforded by blood/blood products or crystalloid resuscitation over extended 'pre-hospital' timelines in a porcine model of militarily relevant traumatic haemorrhagic shock. METHODS: This study underwent local ethical review and was done under the authority of Animals (Scientific Procedures) Act 1986. Forty-five terminally anaesthetised pigs received a soft tissue injury to the right thigh, haemorrhage (30% blood volume and a Grade IV liver injury) and fluid resuscitation initiated 30 min later [Group 1 (no fluid); 2 (0.9% saline); 3 (1:1 packed red blood cells:plasma); 4 (fresh whole blood); or 5 (plasma)]. Fluid (3 ml/kg bolus) was administered during the resuscitation period (maximum duration 450 min) when the systolic blood pressure fell below 80 mmHg. Surviving animals were culled with an overdose of anaesthetic. RESULTS: Survival time was significantly shorter for Group 1 compared to the other groups (P < 0.05). Despite the same triggers for resuscitation when compared to blood/blood components, saline was associated with a shorter survival time (P = 0.145), greater pathophysiological burden and significantly greater resuscitation fluid volume (P < 0.0001). CONCLUSION: When times to advanced medical care are prolonged, resuscitation with blood/blood components is recommended over saline due to the superior quality and stability of resuscitation achieved, which are likely to lead to improved patient outcomes.

Fostering an infant rhesus monkey on to a non-lactating female in a group-housed breeding colony.

The reported case describes how an orphaned infant rhesus macaque (Macaca mulatta) was adopted by a non-lactating female animal from the same breeding group. Experience at our institution over the last 27 years has indicated that fostering infant rhesus macaques on to other females is unsuccessful. However, the described infant was held and carried by another female in his breeding group when his mother was sick. After the death of his natural mother, fostering on to a lactating female was attempted but failed, and he was returned to his breeding group and was adopted by the non-lactating female. The infant was hand-fed by animal care staff, and the feeding regimen is described. The fostering was successful, and the infant has had access to a mother figure and peers, although extensive contact with humans initially was necessary for feeding. This contact did not, however, appear to be detrimental to the mother-infant and peer-infant bond, as the infant did not preferentially seek human contact over monkey contact, and he was at no point rejected by mother or group. The disruption caused by removal and replacement of the infant did not cause agitation or increased fighting within the group. We anticipate that the contact with a matriarchal figure in a primate breeding group will minimize the psychological disturbances frequently found with hand-reared macaques.