title: Effects of arterial blood pressure on rebleeding using Celox and TraumaDEX in a porcine model of lethal femoral injury.
abstract: This study was designed to identify the systolic blood pressure (SBP) and mean arterial pressure (MAP) at which rebleeding occurs when a clot is formed by a hemostatic agent, Celox or TraumaDEX, compared with a standard dressing. Fifteen pigs (5 each) were assigned randomly to 1 of 3 groups: Celox, TraumaDEX, or standard pressure dressing as a control. In all animals, the femoral artery and vein were transected to simulate traumatic injury. Subjects were allowed to hemorrhage 1 minute before treatment. Direct pressure was held 5 minutes followed by application of elastic dressings for 30 minutes. Dressings were removed after 30 minutes, and the wound was observed for rebleeding. Animals demonstrating hemostasis received phenylephrine infusion to increase SBP in 10-mm Hg increments until SBP reached 210 mm Hg or hemorrhage recurred. There were statistically significant differences between Celox (mean SBP, 166.4 mm Hg; mean MAP, 1376 mm Hg) and the control (mean SBP, 88.25 mm Hg; mean MAP, 59.7 mm Hg), and between TraumaDEX (mean SBP, 152.2 mm Hg; mean MAP, 113.2 mm Hg) and the control (P < .05). However, no statistically significant difference existed between Celox and TraumaDEX. Celox and TraumaDEX effectively prevent rebleeding compared with standard dressing.
authors.affiliation: U.S. Army Graduate Program in Anesthesia Nursing, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. james.burgert1@us.army.mil
authors.forename: James M
authors.initials: JM
authors.lastname: Burgert
authors.forename: Brian T
authors.initials: BT
authors.lastname: Gegel
authors.forename: Robert
authors.initials: R
authors.lastname: Austin
authors.forename: Alejandro
authors.initials: A
authors.lastname: Davila
authors.forename: Jacob
authors.initials: J
authors.lastname: Deeds
authors.forename: Lonnie
authors.initials: L
authors.lastname: Hodges
authors.forename: Andrew
authors.initials: A
authors.lastname: Hover
authors.forename: Cheryl
authors.initials: C
authors.lastname: Lockhart
authors.forename: John
authors.initials: J
authors.lastname: Roy
authors.forename: Glenn
authors.initials: G
authors.lastname: Simpson
authors.forename: Stephen
authors.initials: S
authors.lastname: Weaver
authors.forename: William
authors.initials: W
authors.lastname: Wolfe
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001704:Biopolymers / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004195:Disease Models, Animal; D005263:Femoral Artery / Q000293:injuries*; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006490:Hemostatics / Q000627:therapeutic use*; D006973:Hypertension / Q000139:chemically induced / Q000150:complications; D008297:Male; D008863:Microspheres; D010656:Phenylephrine / Q000009:adverse effects; D011134:Polysaccharides / Q000627:therapeutic use*; D011446:Prospective Studies; D011897:Random Allocation; D012008:Recurrence; D013552:Swine; D013599:Systole; D014662:Vasoconstrictor Agents / Q000009:adverse effects
chemical_list: D001704:Biopolymers; C540163:Celox; D006490:Hemostatics; D011134:Polysaccharides; C551011:TraumaDEX; D014662:Vasoconstrictor Agents; D010656:Phenylephrine