Comparative Testing of Hemostatic Dressing in a Large Animal Model (Sus Scorofa) with Severe hepatic Injuries
Abstract
OBJECTIVES: We compared the hemostatic and hemodynamic effects of dilute concentrations of epinephrine soaked gauze and with epinephrine soaked Combat Gauze (CG) in swine with grade IV liver injuries. METHODS: Anesthetized swine were instrumented, splenectomized, and had a grade IV liver injury created. After 30 seconds of free bleeding, damage control liver packing was performed with laparotomy pads soaked in different concentrations of epinephrine (1 mg/L or 2mg/L normal saline) or CG pads soaked in 3mg epinephrine/L normal saline. Hemodynamic and laboratory data were recorded, and blood loss was measured for two hours. Post-mortem histopathology was performed on the liver injury sites. RESULTS: There were no pre-injury differences between groups, and all animals survived the entire two hours. Animals treated with 1 mg/L epi, 2 mg/L epi, and 3 mg/L epi-CG dressings had similar amounts of blood loss (18.7, 22.3, and 21.8 mL/kg respectively, p = 0.85). There were no significant differences between groups in laboratory measurements or physiology measurements. Histopathology revealed no adverse cellular effects from any treatment. CONCLUSION: There were no significant or practical differences in blood loss from animals treated with 1 mg/L and 2 mg/L epinephrine. In a previous experiment, we found that 3 mg/L epinephrine soaked gauze resulted in much less blood loss (16.5 mL/kg) and those animals had similar heart rates and mean arterial pressures as those we observed in this study. Using the more concentrated epinephrine solution with Combat Gauze did not offer any advantage over plain gauze with epinephrine. Therefore, we recommend using a more concentrated epinephrine solution (3 mg epinephrine per liter sterile saline) as a hemostatic dressing in severe liver injuries.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 02, 2013
- Accession Number
- ADA608134
Entities
People
- Hilary Gallogly
Organizations
- David Grant USAF Medical Center