Experimental Modeling of Blood Loss and Hemorrhagic Shock: Past Achievements, Current Recommendations, and Future Challenges (Review)

Acute massive blood loss and hemorrhagic shock in severe trauma remain the leading causes of preventable mortality. Despite the impactfull significance of clinical studies, experimental modeling in laboratory animals remains an indispensable for fundamental studies on the pathophysiology of trauma and hemorrhagic shock, as well as for the initial assessment of the efficacy and safety of therapeutic interventions.

The purpose of this review is to systematize current approaches to the experimental modeling of blood loss, trauma, and hemorrhagic shock, as well as to identify the key factors that determine the translational potential of preclinical studies.

Materials and Methods. We conducted an analysis of domestic and international publications available in the PubMed, Scopus, Web of Science, Google Scholar, and eLIBRARY databases, focusing on experimental models of hemorrhagic shock, including classical and modern approaches to their reproduction, the selection of laboratory animals, and the bioethical aspects of conducting research. Based on the search results, we reviewed 1,819 sources, of which 106 were include

Results. We identified the main types of experimental models of hemorrhagic shock: volume-controlled, blood pressure-controlled, and uncontrolled blood loss models. We demonstrated that the choice of model is determined by the research objectives and requires a balance between standardization, reproducibility, and clinical relevance. A comparative analysis of various types of laboratory animals was conducted to demonstrate differences in their physiology, immune responses, and coagulation reactions affecting the interpretation of results. Key bioethical 3R principles, requirements for anesthesiological care, monitoring, and the selection of study endpoints were discussed in the review.

Conclusion. The translational potential of experimental models is determined by the alignment of the protocol with the study objectives, the appropriate selection of the laboratory model, the standardization of the blood loss procedure, compliance with bioethical requirements, and the use of clinically relevant endpoints. Promising areas for further research include improving the external validity of the models, multicenter preclinical validation of protocols, and the implementation of digital tools for analyzing experimental data.

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