Self-expanding polyurethane polymer improves survival in a model of noncompressible massive abdominal hemorrhage

Abstract

Intraperitoneal polymer injection during massive noncompressible hemorrhage reduces blood loss and improves survival in a lethal, closed-cavity, hepatoportal injury model. Chronic safety and additional efficacy studies in other models are needed.

Self-expanding foam improves survival following a lethal, exsanguinating iliac artery injury

“…These results augment our previous work, where efficacy was established in a low-pressure, high-flow model of massive hepatoportal venous hemorrhage. 9,10 To test similar foam treatments in a different injury model, we selected doses for this study (100 mL and 120 mL) based on effective doses in the hepatoportal injury model. The combination of these findings supports the preclinical efficacy of foam treatment in multiple, lethal, bleeding scenarios.…”

“…This model tested a low-pressure, high-flow venous bleeding scenario. 9,10 A limitation of this model, however, was high-volume crystalloid resuscitation and ventilation with 100% oxygen, 11 features inconsistent with current Tactical Combat Casualty Care (TCCC) guidelines. 12 This initial work specifically tested the durability of hemostasis under conditions known to promote bleeding.…”

Efficacy of a prehospital self-expanding polyurethane foam for noncompressible hemorrhage under extreme operational conditions

“…9,10 Briefly, the foam is generated by a reaction between isocyanate and polyol liquids. To facilitate foam formation, approximately 15% room air was entrained into the polyol phase before deployment using a drill and impellor mixer (Fig.…”

“…9,10 In brief, two liquid precursors were mixed and injected percutaneously into the peritoneal space. The subsequent reaction resulted in expansion throughout the cavity and conformal contact with injured tissue.…”

Massive bleeding following severe blunt trauma: the first minutes that can change everything

“…These include intraperitoneal injection of selfexpanding polyurethane polymer foam for noncompressible massive hemorrhage as well as prehospital thoracotomy, although these methods are as yet of unproven efficacy. [35][36][37] The on-going ''FI in TIC'' study will evaluate whether the prehospital pro-coagulant treatment with fibrinogen concentrate would improve plasmatic coagulation capacity in severe bleeding trauma [38] but until now there is no evidence encouraging the use of fibrinogen concentrate in massive bleeding. Regarding the prehospital administration of Prothrombin Complex Concentrate in the absence of a vitamin K antagonist therapy, data are still lacking.…”