Fig. 1

Time schematic of the polytrauma and hemorrhage model (PHM) and the trauma and hemorrhage model (THM). Non-human primates (NHP) in each group underwent similar pre-operative preparation, anesthesia induction and intubation, as well as insertion of central venous and arterial monitoring devices. In the THM, the NHPs underwent laparoscopic liver injury (60% left hepactectomy at t = 0 min) with 120 min of uncontrolled hemorrhage, pre-hospital resuscitation (20cm³/kg crystalloid at t = 15 min), surgical repair with liver repair and a 10cm³/kg warm whole blood transfusion (t = 120 min), as well as survival phase crystalloid post injury day 1 and 3 (20cm³/kg) and blood product resuscitation for anemia (Hb < 9). In contrast, the PHM NHPs underwent laparoscopic cecal injury prior to liver injury and back soft tissue injury prior to pre-hospital resuscitation. The post injury care in the PHM was goal directed with crystalloid resuscitation for evidence of poor perfusion (low urine output, elevated Cr or lactate), and blood transfusion for evidence of anemia (Hb < 7) and poor perfusion. Laboratory evaluations were performed 2 weeks prior to injury and at the listed time points in both models