The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Abstract

Background. Hemorrhage is the second leading cause of death in civilian trauma and the leading cause of preventable death in military trauma. The purpose of this study was to examine the effectiveness of three hemostatic agents: BleedArrest, TraumaDex, and Celox.Materials and Methods. This was a prospective, experimental study using male Yorkshire swine. The pigs (n [ 5 per group) were randomly assigned to one of the following: BleedArrest, TraumaDex, Celox, or control. 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 min of uncontrolled hemorrhage, one of the hemostatic agents was poured into the wound, followed by standard wound packing. The control group underwent the same procedures with the exception of the hemostatic agents. In all groups, 5 min of direct manual pressure was applied to the wound followed by a standard pressure dressing. After 30 min, dressings were removed, and the amount of bleeding was determined.Results. There were significant differences between the BleedArrest (mean [ 21.2, SD ± 36.6 mL) TraumaDex (mean [ 68, SD ± 103.5 mL) and Celox (mean [ 18.l6, SD ± 41.6 mL) groups compared with Control group (mean [ 230, SD ± 154 mL) (P < 0.05). However, there were no statistically significant difference between BleedArrest, TraumaDex, and Celox groups (P [ 0.478).Conclusions. BleedArrest, Celox, and TraumaDex were statistically and clinically superior at controlling hemorrhage compared with the standard pressure dressing in the control group. Published by Elsevier Inc.

Chitosan‐based agent use for hemostasis after cryptorchidectomy in a horse

“…Packing the wound with granules and suturing it allowed continued control of the hemorrhage, as in our case. Treatment of femoral vessel laceration with application of granules has been reported in some studies with great success; but again, model inconsistency prevents comparisons . Despite this variability, it has received FDA approval as a class 3 drug and is used in the battlefield with up to 97% success .…”

The Effects of QuikClot Combat Gauze, Fluid Resuscitation, and Movement on Hemorrhage Control in a Porcine Model

“…The minimum number of animals was used to obtain a statistically valid result. Using the data from previous studies by Alam, Pusateri, and Sondeen, the investigators calculated a large effect size of 0.6 [12,[14][15][16][17]. Using G-Power 3.00 for Windows, an effect size of 0.6, a power of 0.80, and an alpha of 0.05, it was determined a sample size of 22 was needed for this study.…”

“…Hemostatic agents have been investigated in multiple animal studies to include liver and complex groin injuries. These studies have produced inconsistent and mixed results regarding the effectiveness of hemostatic agents in controlling hemorrhage which indicate the need for additional investigations [6,[9][10][11][12][13][14][15][16].…”

Biosurgicals and Trauma

“…These include differences in the rate of bleeding at the time of dressing application; attempts at simulating a realistic field-use scenario versus an isolated dressing challenge; consideration of the vessel type lacerated and the type and size of laceration; consideration of the duration of hemorrhage before application and arterial pressure level at the time of dressing application; differences in resuscitation regimens after dressing application, and; consideration of whether dressing application is performed with or without prior vascular control [8]. Additional problems with many of the animal studies concerns the large variance in blood loss volumes within groups, such that the standard deviation is often several times the mean blood loss [9]. This makes the detection of statistical superiority for any particular hemorrhage control strategy problematic.…”