Feasibility of blood gas analysis device for injury assessment following limb fracture in rabbits: simulation of the combat casualty evacuation scenario

Abstract

Objective To study the value of point-of-care blood gas analyzer for evaluation of blood loss and the effect of resuscitation following limb fracture in rabbits and explore the feasibility of using the device for injury assessment and guiding resuscitation measures in the scenario of evacuation of combat casualties with limb fractures. Methods Fifteen rabbits were randomized equally into simple fracture group, fracture with massive hemorrhage group, and fracture with hemorrhage resuscitation group (n=5). Models of tibial fracture were established in all the rabbits by cutting the middle part of tibia with a circular saw. Twenty percent of the total blood volume was extracted from the femoral artery in the fracture with hemorrhage group, and in the resuscitation group, the extracted blood was transfused back 30 min after the injury. The level of lactate, base excess value and pH value of the rabbits were measured at 0 and 30 min, and 1 and 2 h using a point-of-care blood gas analyzer. Results The point-of-care blood gas analyzer detected significant changes in base excess value in the rabbits as early as 30 min after tibial fracture with massive hemorrhage, as compared with 2 h following a simple tibial fracture; significant changes in base excess value occurred 2 h after resuscitation for fracture with massive hemorrhage. Significant changes in lactate level were observed 30 min after fracture with massive hemorrhage and 2 h after simple fracture, but not found following resuscitation in the case of fracture with massive hemorrhage. pH value did not show significant variations after the injuries. Conclusion Lactate level and base excess value measured by point-of-care blood gas analysis can be indicative of the severity of limb fracture and blood loss in the course of patient evacuation, and the base excess value following resuscitation before admission can reflect the effect of injury control and resuscitation.

Keywords

• limb fracture
• hemorrhagic shock
• damage control and resuscitation