title: The efficacy of a novel saline/bipolar radiofrequency energy instrument for arresting ongoing solid and non-solid organ hemorrhage in a swine model.
abstract: BACKGROUND
  Ongoing hemorrhage is often life threatening and can be challenging to stop in critically injured patients. Traditional techniques for addressing this issue include high voltage cautery (Bovie), topical hemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a novel energy device for arresting ongoing bleeding from both solid and non-solid organs within a swine model.
  
  
  METHODS
  A novel instrument utilizing bipolar radiofrequency (RF) energy which acts to ignite/boil dripping saline from a small hand piece was employed to arrest ongoing hemorrhage from an escalating series of injuries in large male swine. Liver, spleen, kidney, lung, heart, inferior vena cava and abdominal wall targets were evaluated and digitally recorded. Methodology was descriptive.
  
  
  RESULTS
  Four large male swine received escalating injuries to their liver, spleen, kidney, lung, heart, inferior vena cava and abdominal wall. Injury patterns included a variety of surface decapsulation, superficial lacerations, deep lacerations, "through and through" missiles and complete transections. Application of the bipolar/RF instrument to sites of ongoing hemorrhage was successful in 97% of all scenarios. Depth of tissue penetration via microscopic evaluation ranged from 1.1mm to 3.0mm depending on the target organ composition. No air leaks were observed following application to the bleeding lung. Surgeon reported 'ease of use' score was high (4.8/5).
  
  
  CONCLUSIONS
  This energy technology is successful in arresting ongoing hemorrhage from varying intensities of traumatic injuries to the liver, spleen, kidney, abdominal wall, lung and heart in the swine model. Additional testing is required before advocating its use on any thoracic organs.
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: ball.chad@gmail.com.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, United States. Electronic address: andre.campbell@ucsf.edu.
authors.forename: Andre
authors.initials: A
authors.lastname: Campbell
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: sean.grondin@albertahealthservices.ca.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Grondin
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: elijah.dixon@albertahealthservices.ca.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
mesh_terms: D000007:Abdominal Injuries / Q000473:pathology*; D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation*; D004195:Disease Models, Animal; D004564:Electrocoagulation / Q000295:instrumentation*; D006470:Hemorrhage / Q000601:surgery*; D006487:Hemostasis / Q000502:physiology*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D007668:Kidney / Q000473:pathology; D022125:Lacerations / Q000473:pathology*; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D008297:Male; D013154:Spleen / Q000473:pathology; D013552:Swine
keywords: Energy device; Hemorrhage; Organ injury; Swine; Trauma laparotomy