Journal article
Kaolin-based hemostatic dressing improves hemorrhage control from a penetrating inferior vena cava injury in coagulopathic swine
The journal of trauma and acute care surgery, Vol.83(1), pp.71-76
01 Jul 2017
PMID: 28452883
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Retrohepatic inferior vena cava (RIVC) injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Control+; Z-Medica, Wallingford, CT) would improve hemorrhage control from a penetrating RIVC injury compared with packing with standard laparotomy sponges alone.
METHODS: Twelve male Yorkshire pigs received a 25% exchange transfusion of blood for refrigerated normal saline to induce a hypothermic coagulopathy. A laparotomy was performed and a standardized 1.5 cm injury to the RIVC was created which was followed by temporary abdominal closure and a period of uncontrolled hemorrhage. When the mean arterial pressure reached 70% of baseline, demonstrating hemorrhagic shock, the abdomen was re-entered, and the injury was treated with perihepatic packing using standard laparotomy sponges (L; n = 6) or a new kaolin-based hemostatic dressing (K; n = 6). Animals were then resuscitated for 6 hours with crystalloid solution. The two groups were compared using the Wilcoxon rank sum test and Fisher exact test. A p value of 0.05 or less was considered statistically significant.
RESULTS: There was no difference in the animal's temperature, heart rate, mean arterial pressure, cardiac output, and blood loss at baseline or before packing was performed (all p > 0.05). In the laparotomy sponge group, five of six pigs survived the entire study period, whereas all six pigs treated with kaolin-based D2 hemostatic dressings survived. Importantly, there was significantly less blood loss after packing with the new hemostatic kaolin-based dressing compared with packing with laparotomy sponge (651 +/- 180 mL vs. 1073 +/- 342 mL; p <= 0.05).
CONCLUSION: These results demonstrate that the use of this new hemostatic kaolin-based dressing improved hemorrhage control and significantly decreased blood loss in this penetrating RIVC model. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Details
- Title
- Kaolin-based hemostatic dressing improves hemorrhage control from a penetrating inferior vena cava injury in coagulopathic swine
- Creators
- Kiavash R. Koko - Cooper University HospitalBrian M. McCauley - Cooper Univ Hosp, Camden, NJ USAJohn P. Gaughan - Cooper University HospitalRyan S. Nolan - Cooper University HospitalMarc W. Fromer - Cooper University HospitalAshleigh L. R. Hagaman - Cooper Univ Hosp, Camden, NJ USARachel L. Choron - Cooper University HospitalSpencer A. Brown - Cooper University HospitalJoshua P. Hazelton - Cooper University Hospital
- Publication Details
- The journal of trauma and acute care surgery, Vol.83(1), pp.71-76
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Grant note
- Cooper Foundation company Z-Medica
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000403903100012
- Scopus ID
- 2-s2.0-85024400334
- Other Identifier
- 991022057018604721
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InCites Highlights
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- Web of Science research areas
- Critical Care Medicine
- Surgery