Comparative analysis of hemostatic agents in a swine model of lethal groin injury

Hasan B. Alam, Gemma B. Uy, Dana Miller, Elena Koustova, Timothy Hancock, Ryan Inocencio, Daniel Anderson, Orlando Llorente, Peter Rhee

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132 Scopus citations

Abstract

Background:Techniques for better hemorrhage control after injury could change outcome. A large-animal model of lethal, uncontrolled hemorrhage was developed to test whether the use of various hemostatic agents would decrease bleeding and improve early survival.Methods:A complex groin injury was created in 30 Yorkshire swine (42-55 kg) to produce uncontrolled hemorrhage. This injury included semitransection of the proximal thigh and complete division of the femoral artery and vein. After 5 minutes, the animals were randomized to (n = 6 animals per group) no dressing (ND), standard dressing (SD), SD and Rapid Deployment Hemostat (RDH) bandage, SD and QuikClot hemostatic agent (QC), or SD and TraumaDEX (TDEX). Limited volume 0.9% saline (1,000 mL over 30 minutes) resuscitation was started 30 minutes after injury. We measured blood loss, early mortality (180 minutes), and physiologic markers of hemorrhagic shock (e.g., cardiac output, blood pressure, hemoglobin, metabolic acidosis).Results:Application of wound dressing decreased mortality in all groups compared with the ND group (83% mortality). However, this difference was significant (p < 0.05) only for the QuikClot hemostatic agent (0% mortality). Before the application of dressing (first 5 minutes), there were no differences in blood loss between the groups. After application of dressings, the QC group had the lowest blood loss (4.4 ± 1.4 mL/kg).Conclusion:Of the hemostatic agents tested, QuikClot improved survival and decreased bleeding in a swine model of lethal vascular and soft tissue injury.

Original languageEnglish (US)
Pages (from-to)1077-1082
Number of pages6
JournalJournal of Trauma
Volume54
Issue number6
DOIs
StatePublished - Jun 2003

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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    Alam, H. B., Uy, G. B., Miller, D., Koustova, E., Hancock, T., Inocencio, R., Anderson, D., Llorente, O., & Rhee, P. (2003). Comparative analysis of hemostatic agents in a swine model of lethal groin injury. Journal of Trauma, 54(6), 1077-1082. https://doi.org/10.1097/01.TA.0000068258.99048.70