Comparison of Topical Hemostatic Agents in a Swine Model of Extremity Arterial Hemorrhage: BloodSTOP iX Battle Matrix vs. QuikClot Combat Gauze

BloodSTOP iX Battle Matrix (BM) and QuikClot Combat Gauze (CG) have both been used to treat traumatic bleeding. The purpose of this study was to examine the efficacy and initial safety of both products in a swine extremity arterial hemorrhage model, which mimics combat injury. Swine (37.13 0.56 kg,...

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Main Authors: O'Hara,Reginald B, Li,Huixi, Wang,Lin, Alwaal,Amjad, Lee,Yung-Chin, Reed-Maldonado,Amanda, Spangler,Taylor A, Banie,Lia, Lin,Guiting
Format: Report
Language:English
Subjects:
arteries
bandages
blood coagulation
BloodSTOP Battle Matrix
cardiovascular physiological phenomena
combat injuries
damage control
dressings
hemorrhage control
Hemorrhagic shock
hemostasis
Hemostatic agents
QuikClot Combat Gauze
surgical procedures
swine
tissues (biology)
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Summary:BloodSTOP iX Battle Matrix (BM) and QuikClot Combat Gauze (CG) have both been used to treat traumatic bleeding. The purpose of this study was to examine the efficacy and initial safety of both products in a swine extremity arterial hemorrhage model, which mimics combat injury. Swine (37.13 0.56 kg, NBM = 11, NCG = 9) were anesthetized and splenectomized. We then isolated the femoral arteries and performed a 6-mm arteriotomy. After 45 s of free bleeding, either BM or CG was applied. Fluid resuscitation was provided to maintain a mean arterial pressure of 65 mmHg. Animals were observed for 3 h or until death. Fluoroscopic angiography and wound stability challenge tests were performed on survivors. Tissue samples were collected for histologic examination. Stable hemostasis was achieved in 11/11 BM and 5/9 CG subjects, with recovery of mean arterial pressure and animal survival for 3 h [p 0.05, odds ratio (OR) = 18.82 (0.85415.3)]. Time to stable hemostasis was shorter for the BM-treated group (4.8 2.5 min vs. 58 20.1 min; median = 2, interquartile range (IQR) = 0 min vs. median = 60, IQR = 120 min; p 0.05) and experienced longer total stable hemostasis (175.2 2.5 min vs. 92.4 29.9 min; median = 178, IQR = 0 min vs. median = 120, IQR = 178 min; p 0.05). Post treatment blood loss was lower with BM (9.5 2.4 mL/kg, median = 10.52, IQR = 13.63 mL/kg) compared to CG (29.9 9.9 mL/kg, median = 29.38, IQR = 62.44 mL/kg) (p = 0.2875). Standard BM products weighed less compared to CG (6.9 0.03 g vs. 20.2 0.4g) (p 0.05) and absorbed less blood (3.4 0.8 g vs. 41.9 12.3 g) (p 0.05). Fluoroscopic angiography showed recanalization in5/11 (BM) and 0/5 (CG) surviving animals [p = 0.07, OR = 9.3 (0.41208.8)]. International Jourla of Molecular Sciences , 545, 01 Jan 0001, 01 Jan 0001,