Clinical and laboratory predictors of blood loss in young swine: a model for pediatric hemorrhage

Clinical and laboratory predictors of blood loss in young swine: a model for pediatric hemorrhage Background The pediatric patient’s response to hemorrhage as a function of young age is not well understood. As a result, there is no consensus on optimal resuscitation strategies for hemorrhagic shock in pediatric patients, or on the identification of clinical triggers to prompt implementation. The study objective was to develop a model of pediatric hemorrhage using young pigs to simulate school-aged children, and determine clinical and laboratory indicators for significant hemorrhage. Materials and methods 29 non-splenectomized female pigs, aged 3 months, weighing 30–40 kg, were randomized into groups with varying degrees of hemorrhage. Bleeding occurred intermittently over 5 h while the animals were anesthetized but spontaneously breathing. Various physiologic and biochemical markers were used to monitor the piglets during hemorrhage. Results Swine experiencing up to 50% hemorrhage survived without exception throughout the course of hemorrhage. 80% (4/5) of the animals in the 60% hemorrhage group survived. Need for respiratory support was universal when blood loss reached 50% of estimated blood volume. Blood pressure was not useful in classifying the degree of shock. Heart rate was helpful in differentiating between the extremes of blood loss examined. Arterial pCO pH, lactate, HC O and creatinine 2, 3 levels, as well as urine output, changed http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Surgery International Springer Journals

Clinical and laboratory predictors of blood loss in young swine: a model for pediatric hemorrhage

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply
Subject
Medicine & Public Health; Pediatrics; Surgery; Pediatric Surgery
ISSN
0179-0358
eISSN
1437-9813
D.O.I.
10.1007/s00383-018-4287-4
Publisher site
See Article on Publisher Site

Abstract

Background The pediatric patient’s response to hemorrhage as a function of young age is not well understood. As a result, there is no consensus on optimal resuscitation strategies for hemorrhagic shock in pediatric patients, or on the identification of clinical triggers to prompt implementation. The study objective was to develop a model of pediatric hemorrhage using young pigs to simulate school-aged children, and determine clinical and laboratory indicators for significant hemorrhage. Materials and methods 29 non-splenectomized female pigs, aged 3 months, weighing 30–40 kg, were randomized into groups with varying degrees of hemorrhage. Bleeding occurred intermittently over 5 h while the animals were anesthetized but spontaneously breathing. Various physiologic and biochemical markers were used to monitor the piglets during hemorrhage. Results Swine experiencing up to 50% hemorrhage survived without exception throughout the course of hemorrhage. 80% (4/5) of the animals in the 60% hemorrhage group survived. Need for respiratory support was universal when blood loss reached 50% of estimated blood volume. Blood pressure was not useful in classifying the degree of shock. Heart rate was helpful in differentiating between the extremes of blood loss examined. Arterial pCO pH, lactate, HC O and creatinine 2, 3 levels, as well as urine output, changed

Journal

Pediatric Surgery InternationalSpringer Journals

Published: May 28, 2018

References

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