Hemostatic Agents for Control of Intracavitary Non-Compressible Hemorrhage: An Overview of Current Results
Abstract
The majority (~80%) of hemorrhagic deaths on the battlefield are due to intracavitary hemorrhage that is not accessible for direct compression and cannot be treated with externally applied hemostatic agents. In an attempt to address this issue, a project was initiated to evaluate the efficacy of different hemostatic products when introduced into a closed hemorrhaging body cavity. Two thrombin-based hemostatic agents have been tested thus far in rat and rabbit models. In the initial phase, these agents were tested by direct and immediate application over severe parenchymal injury without compression in open-abdomen models. In the second phase of the project, the hemostatic agents were infused 5 minutes after a liver injury in closed-abdomen injury models. In the phase 1 open abdomen studies, both hemostatic agents decreased blood loss when compared with placebo-treated control animals. This decreased blood loss corresponded to an increase in survival rates that was not, however, statistically significant. In the phase 2 closed abdomen study neither hemostatic agent was able to produce a significant change in blood loss or survival rates when compared to control animals. The hemostatic properties of both hemostatic agents involve binding with injured tissues. Such characteristics require contact of these agents with damaged, bleeding tissues. In the closed abdomen model, contact is made difficult by ongoing hemorrhage and pooled blood. The failure of both products to demonstrate efficacy may also have been due to model design. In the severe liver injury model, bleeding is most severe in the first few minutes after the injury that unless treated promptly the consequences cannot be reversed by later interventions. Additional studies in more appropriate models with alternative hemostatic agents will further evaluate the potential for intracavitary approach to treat the noncompressible hemorrhage.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2004
- Accession Number
- ADA444688
Entities
People
- Bijan Kheirabadi
- Harold G. Klemcke
Organizations
- United States Army Institute of Surgical Research