Multiomics Signatures of Coagulopathy in a Polytrauma Swine Model Contrasted with Severe Multisystem Injured Patients

Area of Science:

• Traumatology
• Translational Medicine
• Systems Biology

Background:

• Trauma-induced coagulopathy (TIC) is a major cause of preventable death in severe trauma patients.
• Understanding TIC's molecular basis is crucial for developing new treatments.
• Novel swine models offer insights into human trauma responses.

Purpose of the Study:

• To investigate multiomics and viscoelastic changes in a novel swine model of polytrauma.
• To compare these findings with severely injured human patients.
• To evaluate the impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) on TIC.

Main Methods:

• Utilized a novel swine model for induced polytrauma.
• Performed multiomics analysis (genomics, proteomics, metabolomics) and viscoelastic measurements.
• Compared swine model data with clinical data from trauma patients.
• Assessed the effects of REBOA with varying aortic balloon placement (Zone-1 vs. Zone-3).

Main Results:

• Molecular signatures of TIC were linked to altered coagulation, inflammation, and hemolysis.
• Swine model findings mirrored patterns seen in human trauma patients with multisystem injuries.
• REBOA in Zone-1 exacerbated ischemic damage and mitochondrial dysfunction.
• REBOA in Zone-3 improved coagulation and demonstrated a beneficial effect on TIC.

Conclusions:

• The polytrauma swine model is translationally relevant for studying TIC.
• REBOA's effectiveness in managing TIC is dependent on aortic balloon placement.
• Targeting specific zones during REBOA may optimize treatment for trauma patients.