Development and description of a porcine model of combat casualty care for traumatic-hemorrhagic shock research and medical training.
European journal of trauma and emergency surgery : official publication of the European Trauma Society May 22, 2025 Venetia Cardona, Frédérique Dufour-Gaume, Florent Montespan et al.
Most animal models of hemorrhagic shock with multiple injuries only reproduce soft tissue damage, limiting their relevance to battlefield trauma. In a pig model of combat-related hemorrhagic shock plus bilateral femur fractures, three anesthetics were compared: ketamine-midazolam (KM), isoflurane (ISO), and alfaxalone (ALFA). Both KM and ISO produced hemodynamic changes typical of severe shock, while ALFA caused extreme, persistent tachycardia even after resuscitation, indicating poor tolerance. The authors conclude that ALFA is unsuitable for this model, whereas KM and ISO are both appropriate, with KM being most clinically relevant for prehospital or austere military medical care.