title: New hemostatic dressing (FAST Dressing) reduces blood loss and improves survival in a grade V liver injury model in noncoagulopathic swine.
abstract: BACKGROUND
  We performed this study to evaluate the hemostatic efficacy of the FAST Dressing in treating a grade V liver injury in noncoagulopathic swine.
  
  
  METHODS
  Sixteen female splenectomized, noncoagulopathic swine underwent reproducible grade V liver injuries. The animals were blindly randomized to two treatment groups: (1) FAST Dressing (n = 8) or (2) IgG placebo dressing (n = 8). After 30 seconds of uncontrolled hemorrhage, dressings and manual compression were applied at 4-minute intervals. The number of dressings used, time to hemostasis, total blood loss, mean arterial pressure, blood chemistry, and total resuscitation fluid volume were monitored for 2 hours after injury.
  
  
  RESULTS
  The mean total blood loss was 412.5 mL (SD 201.3) for the FAST Dressing group compared with 2296.6 mL (SD 1076.0) in the placebo group (p < 0.001). All animals in the FAST Dressing group achieved hemostasis and survived for the duration of the experiment (2 hours) after injury, whereas none of the animals in the placebo group attained hemostasis or survived to 2 hours after injury (p < 0.001). The mean time to hemostasis was 6.6 minutes (SD 2.5). A median of five dressings (mean absolute deviation 1.0, p = 0.007) was sufficient to control hemorrhage in the FAST Dressing group.
  
  
  CONCLUSIONS
  The FAST Dressing reduced blood loss and improved survival compared with placebo in a noncoagulopathic, grade V liver injury swine model.
authors.affiliation: Division of Clinical and Outcomes Research, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland 21201, USA.
authors.forename: Gerard P
authors.initials: GP
authors.lastname: De Castro
authors.forename: Martin J
authors.initials: MJ
authors.lastname: MacPhee
authors.forename: Ian R
authors.initials: IR
authors.lastname: Driscoll
authors.forename: Dawson
authors.initials: D
authors.lastname: Beall
authors.forename: June
authors.initials: J
authors.lastname: Hsu
authors.forename: Shijun
authors.initials: S
authors.lastname: Zhu
authors.forename: John R
authors.initials: JR
authors.lastname: Hess
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Scalea
authors.forename: Grant V
authors.initials: GV
authors.lastname: Bochicchio
mesh_terms: D000818:Animals; D001458:Bandages; D001774:Blood Chemical Analysis; D001794:Blood Pressure; D004195:Disease Models, Animal; D005260:Female; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques; D008099:Liver / Q000293:injuries*; D010919:Placebos; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods; D018709:Statistics, Nonparametric; D013552:Swine
chemical_list: D010919:Placebos