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Trauma Induced Coagulopathy pp 545–565Cite as

Animal Models of Trauma Induced Coagulopathy

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Abstract

Animal models serve an essential role in the study of trauma-induced coagulopathy by allowing the control of experimental variables in a reproducible setting and serve as a platform for therapeutic testing. Large animal models offer advantages in terms of clinical realism, while small animal models are frequently used in mechanistic studies. In addition to traditional coagulation assays such as prothrombin time and activated thromboplastin time, more recent studies have used thromboelastography/thromboelastometry, platelet function testing, and measured the concentrations of circulating clotting factors. Models of isolated injury, such as hemorrhage, sepsis, and acidosis, have demonstrated an overall hypocoagulopathic state. In contrast, traumatic brain injury (TBI) with or without additional injuries induces an immediate activation of the coagulation system. Platelet and endothelial dysfunction has been documented in greater detail in TBI models relative to non-TBI models. Complex, multiple-insult models have shown hypocoagulopathic derangements that positively correlate with increases in injury severity. Aggressive crystalloid resuscitation, while aimed at reversing hypotension following trauma, creates hemodilution-induced coagulopathy. Artificial colloids can induce a hypocoagulopathic state, while plasma-based agents have shown promise in reversing both coagulation cascade derangements and platelet dysfunction. Animal models have enhanced our mechanistic understanding of TIC and served as a laboratory for testing promising therapies. However, future studies should more closely examine the temporal changes in coagulation immediately post-injury, collect pre-intervention coagulation data, and develop robust models of hyperfibrinolysis.

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Acknowledgement

Dr. Alam would like to acknowledge research support provided by numerous grants by the Office of Naval Research (including N000140910378, and N000141310071), US Army Medical Research and Materiel Command (W81XWH-09-1-0520), Defense Advanced Research Projects Agency (W911NF-06-1-0220), and National Institutes of Health (R01GM084127). The authors would like to thank Simone E. Dekker for her insightful comments on earlier versions of this chapter.

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Authors and Affiliations

  1. Trauma Translational and Clinical Research Laboratory, Department of Surgery, University of Michigan Hospital, Ann Arbor, MI, USA

    Ted Bambakidis

  2. Case Western Reserve University, School of Medicine, Cleveland, OH, USA

    Ted Bambakidis

  3. Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Martin Sillesen

  4. Section of General Surgery, University of Michigan, 1500 East Medical Center Drive, TC 2920B, Ann Arbor, MI, USA

    Hasan B. Alam

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  1. Ted Bambakidis
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  2. Martin Sillesen
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  3. Hasan B. Alam
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Correspondence to Hasan B. Alam .

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Editors and Affiliations

  1. Dept of Surgery & Trauma Research Center, Univ of Colorado School of Medicine, Aurora, Colorado, USA

    Eduardo Gonzalez

  2. Dept of Surgery & Trauma Research Center, Univ of Colorado School of Medicine, Aurora, Colorado, USA

    Hunter B. Moore

  3. Dept of Surgery & Trauma Research Center, Univ of Colorado Sch of Med&Denver Healt, Denver, Colorado, USA

    Ernest E. Moore

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Bambakidis, T., Sillesen, M., Alam, H.B. (2016). Animal Models of Trauma Induced Coagulopathy. In: Gonzalez, E., Moore, H., Moore, E. (eds) Trauma Induced Coagulopathy. Springer, Cham. https://doi.org/10.1007/978-3-319-28308-1_34

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  • DOI: https://doi.org/10.1007/978-3-319-28308-1_34

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