The Effects of Hemostatic Agents and Hypothermia Control in a Porcine Model

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Name: Arthur (Don) Johnson

Rank: Col(ret)

Organization: The Geneva Foundation

Performance Site: University of Texas Health Science Center at San Antonio, TX

Year Published: 2009

Abstract Status: Final

Abstract

Purpose: The primary purposes of this study were to determine the effectiveness of QuikClot Combat Gauze (QCG) and BleedArrest in a normovolemic model. In addition, the purposes were to investigate the effectiveness of QCG in a hemodiluted and resuscitated model; in a hypothermic model; and movement model. 

Design: Studies were prospective, experimental design.

Methods: Swine were randomly assigned to experimental groups (normovolemic; resuscitated;  hemodiluted after bleed; increased systolic blood pressure; hypothermic) or to a control group for each of the experimental groups. To simulate a trauma injury, the investigators generated a complex groin injury with transection of the femoral artery and vein in all pigs. After 1 minute of uncontrolled hemorrhage, the hemostatic agent was placed into the wound followed by standard wound packing. The control group underwent the same procedures with the exception of the hemostatic agent. In all groups, 5 minutes of direct manual pressure was applied to the wound followed by a standard pressure dressing. After 30 minutes, dressings were removed, and the amount of bleeding was determined. In the case of hemodilution, up to 5 liters of fluid were administered after hemostatis; in the case of prior hemodilution, 30% pigs’ blood volume was exsanguinated, and a 3:1 ratio was administered; in the case of hypothermia, a temperature < 36 degrees C was achieved; and in the case of movements, the number of extremity movements were counted before rebleeding occurred.

Sample: Yorkshire swine

Analysis: MANOVA was used.

Findings: In all the studies (normovolemic; hemodiluted; resuscitated; hypothermic; and manipulation of systolic blood pressure, and movement of extremities, QCG was effective in hemorrhage control (p < 0.05).

Implications for Military Nursing: QCG is effective in hemorrhage control. Our studies support the decision of the military to use QCG as the first-line hemostatic agent for use in treatment of severe hemorrhage.

 

Final Report is available on NTRL at: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2015105...