Development of a Perfused Cadaver Model of Exsanguinating Hemorrhage for Procedural Training and Device Evaluation

Introduction: We demonstrate a novel perfused cadaver model with realistic tissue feel, true anatomy, and replicating key local physiologic parameters of acute life-threatening hemorrhage. Validation of fidelity is accomplished through measurement of hemodynamics and video confirmation of hemorrhage control. Methods: A pulsatile pump was attached to the ascending and descending aorta of a fresh or fresh-frozen cadaver via plastic tubing. The pump provided forward flow at 60 beats per minute of water with red coloring, simulating circulation. Flow probes were attached to arteries immediately proximal to an injury/transection site, with pressure probes cannulated in a contralateral artery that indicated systemic pressure. Hemorrhage control was performed using three different devices, with cessation of hemorrhage confirmed via physiologic data as well as visually. Results: Physiologic data confirmed that hemorrhage control was obtained under expected parameters. Flow immediately proximal to the injury site was negligible after hemorrhage control was attempted, while systemic pressure increased. When the hemorrhage control device was released, bleeding resumed and flow increased as measured proximal to the wound. Video recordings served as visual confirmation of hemorrhage control obtained using various devices. Conclusions: Our perfused cadaver model offers realistic tissue feel and simulated blood flow with a pulse, with hemorrhage control correlating to realistic physiologic parameters. The result is an accurate representation of visual, tactile, and physiologic modeling for acute life-threatening limb hemorrhage control.