Related Experiment Video
Updated: Dec 28, 2025
Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock
Published on: November 3, 2023
Intravenous and Intraosseous Blood Transfusion With Three Different Pediatric Pressure Transfusion Strategies in an
William Bianchi1, Taylor George1, Christian McEvoy1
1Naval Medical Center Portsmouth, Department of Emergency Medicine, Combat Trauma Research Group.
Insights
This study tested blood transfusion devices in young swine to find the best method for pediatric hemorrhagic shock resuscitation. The LifeFlow device showed faster rates but increased hemolysis via intravenous access.
Area of Science:
- Veterinary Medicine
- Pediatric Critical Care
- Trauma Resuscitation
Background:
- Exsanguination is a leading cause of preventable death in military conflicts, particularly affecting children.
- Intraosseous (IO) access is often necessary for pediatric vascular access during emergencies.
- Optimal blood transfusion methods for pediatric hemorrhagic shock remain unclear.
Purpose of the Study:
- To test the feasibility of an immature swine model for comparing blood infusion device efficacy.
- To evaluate transfusion device performance via intravenous (IV) and IO access in a pediatric-like model.
- To determine optimal resuscitation strategies for pediatric hemorrhagic shock.
Main Methods:
- Eighteen immature swine underwent bleeding (31% of blood volume).
- Autologous blood was transfused using pressure bag, push-pull (PP), or LifeFlow Rapid Infuser via IO or IV access.
- Hemodynamic parameters and hemolysis were monitored for 60 minutes.
Main Results:
- LifeFlow achieved significantly higher flow rates compared to pressure bag and PP devices.
- The IV LifeFlow group exhibited substantially higher levels of hemolysis (6-fold increase in plasma-free hemoglobin).
- The IO access model proved feasible for evaluating transfusion devices.
Conclusions:
- While IV LifeFlow offers rapid infusion, increased hemolysis necessitates caution.
- The immature swine model is suitable for assessing transfusion device efficacy in pediatric resuscitation.
- Further research is needed to optimize transfusion methods for pediatric hemorrhagic shock.
Introduction:
Exsanguination remains the leading cause of preventable death in military conflicts, and pediatric casualties are common. Transfusion is crucial to preserve life, but vascular access is challenging in children, so intraosseous (IO) access is often required. However, the optimal transfusion method is unclear. There was therefore the need for feasibility testing of a model for contrasting the efficacy of blood infusion devices via intravenous (IV) and IO access in immature swine with bone densities similar to children.
Materials And Methods:
Eighteen immature swine (21 ± 1 kg) were bled 31% of estimated blood volume and then received autologous blood delivered by pressure bag, push-pull (PP), or LifeFlow Rapid Infuser via IO (15-gauge IO needle placed in the humeral head) or IV (auricular 20-gauge), with monitoring for 60 minutes.
Results:
Flow rates for LifeFlow (172 ± 28 mL/kg) were 4-fold higher than pressure bag (44 ± 13 mL/kg, P < 0.001) and 80% higher than PP (95 ± 28 mL/kg, P < 0.02). However, higher hemolysis was evident in the IV LifeFlow condition, with 6-fold more plasma-free hemoglobin than other conditions (P < 0.0001).
Conclusions:
IV LifeFlow conferred higher flows, but higher hemolysis in this pilot study demonstrates the feasibility of an immature swine model toward determining optimal methods for resuscitating children with hemorrhagic shock.
