Abstract
Background Major trauma often results in significant bleeding and coagulopathy, posing a substantial
clinical burden. To understand the underlying pathophysiology and to refine clinical
strategies to overcome coagulopathy, preclinical large animal models are often used.
This review scrutinizes the clinical relevance of large animal models in hemostasis
research, emphasizing challenges in translating findings into clinical therapies.
Methods We conducted a thorough search of PubMed and EMBASE databases from January 1, 2010,
to December 31, 2022. We used specific keywords and inclusion/exclusion criteria centered
on large animal models.
Results Our review analyzed 84 pertinent articles, including four animal species: pigs, sheep,
dogs, and nonhuman primates (NHPs). Eighty-five percent of the studies predominantly
utilized porcine models. Meanwhile, sheep and dogs were less represented, making up
only 2.5% of the total studies. Models with NHP were 10%. The most frequently used
trauma models involved a combination of liver injury and femur fractures (eight studies),
arterial hemorrhage (seven studies), and a combination of hemodilution and liver injury
(seven studies). A wide array of coagulation parameters were employed to assess the
efficacy of interventions in hemostasis and bleeding control.
Conclusions Recognizing the diverse strengths and weaknesses of large animal models is critical
for trauma and hemorrhage research. Each model is unique and should be chosen based
on how well it aligns with the specific scientific objectives of the study. By strategically
considering each model's advantages and limitations, we can enhance our understanding
of trauma and hemorrhage pathophysiology and further advance the development of effective
treatments.
Keywords
trauma - hemorrhage - coagulation - hemostasis - animal models
