Determination of Efficacy of New Hemostatic Dressings in a Model of Extremity Arterial Hemorrhage in Swine
Abstract
Background: The HemCon (HC) bandage and QuickClot have been used over the past 6 years for treating external compressible hemorrhage in combat casualties. Previously, we tested three new hemostatic agents in granular/powder forms that were superior to these products. In this study, four new dressings (preselected) that are more suitable for battlefield application were evaluated. The efficacy and acute safety of the dressings were tested in our standard arterial hemorrhage model. Methods: Anesthetized pigs (n = 38, 37 kg) were instrumented, and arterial blood was collected for hematological and coagulation assays. After splenectomy, the right femoral artery was isolated, injured (6 mm arteriotomy), and unrestricted bleeding allowed for 45 seconds. A hemostatic dressing (HC RTS [n = 6], Celox-D [CXb, n = 6], TraumaStat [TS, n = 10], Combat Gauze [CG, n = 10], or placebo gauze [PG, n = 6]) was then applied over the wound randomly and compressed for 2 minutes. Fluid resuscitation was administered and titrated to maintain a mean arterial pressure of 65 mm Hg. Animals were observed for 180 minutes or until death. Computed tomography angiography was performed on survivors and tissues were collected for histology. Results: No differences were found in baseline blood measures, pretreatment blood loss or fluid infusion among groups. HCs and CXb testing discontinued after six unsuccessful tests, and the data were excluded. Stable hemostasis was achieved in two PG, two TS, and eight CG pigs in remaining groups resulting in stabilized mean arterial pressure and significantly different survival rates (20-80 %, p= 0.03).
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2009
- Accession Number
- ADA627567
Entities
People
- Bijan Shams Kheirabadi
- J. S. Estep
- John B Holcomb
- Michael A. Dubick
- Michael R. Scherer
Organizations
- United States Army Institute of Surgical Research