Abstract
BACKGROUND: Although coagulopathy can be very common in severe traumatic shock patients, the exact incidence and mechanism remain unclear. In this study, a traumatic shock rabbit model with special abdomen injuries was developed and evaluated by examining indicators of clotting and fibrinolysis. METHODS: Forty New Zealand white rabbits were randomly divided into four groups: group 1 (sham), group 2 (hemorrhage), group 3 (hemorrhage-liver injury), and group 4 (hemorrhage-liver injury/intestinal injury-peritonitis). Coagulation was detected by thromboelastography before trauma (T(0)), at 1 hour (T(1)) and 4 hours (T(2)) after trauma. RESULTS: Rabbits that suffered from hemorrhage alone did not differ in coagulation capacity compared with the sham group. The clot initiations (R times) of group 3 at T(1) and T(2) were both shorter than those of groups 1, 2, and 4 (P<0.05). In group 4, clot strength was decreased at T(1) and T(2) compared with those in groups 1, 2, and 3 (P<0.05), whereas the R time and clot polymerization were increased at T(2) (P<0.05). The clotting angle significantly decreased in group 4 compared with groups 2 and 3 at T(2) (P<0.05). CONCLUSION: This study suggests that different abdominal traumatic shock show diverse coagulopathy in the early phase. Isolated hemorrhagic shock shows no obvious effect on coagulation. In contrast, blunt hepatic injury with hemorrhage shows hypercoagulability, whereas blunt hepatic injury with hemorrhage coupled with peritonitis caused by a ruptured intestine shows a tendency toward hypocoagulability.