Effects of arterial blood pressure on rebleeding using Celox and TraumaDEX in a porcine model of lethal femoral injury.
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.
Burgert
James M
JM
U.S. Army Graduate Program in Anesthesia Nursing, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. james.burgert1@us.army.mil
Gegel
Brian T
BT
Austin
Robert
R
Davila
Alejandro
A
Deeds
Jacob
J
Hodges
Lonnie
L
Hover
Andrew
A
Lockhart
Cheryl
C
Roy
John
J
Simpson
Glenn
G
Weaver
Stephen
S
Wolfe
William
W
Johnson
Don
D
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
D001704:Biopolymers; C540163:Celox; D006490:Hemostatics; D011134:Polysaccharides; C551011:TraumaDEX; D014662:Vasoconstrictor Agents; D010656:Phenylephrine