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An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot
Objectives: Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the b...
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| Published in: | Academic emergency medicine 2008-01, Vol.15 (1), p.74-81 |
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| Main Authors: | , , , , |
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| cites | cdi_FETCH-LOGICAL-c4799-8f173fad57d19fa46c1a3f3f1e45d4037dc58761ae0e4e0ebd0909b9adfb4caf3 |
| container_end_page | 81 |
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| container_title | Academic emergency medicine |
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| creator | Kozen, Buddy G. Kircher, Sara J. Henao, Jose Godinez, Fermin S. Johnson, Andrew S. |
| description | Objectives: Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury.
Methods: A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.
Results: CX reduced rebleeding to 0% (p |
| doi_str_mv | 10.1111/j.1553-2712.2007.00009.x |
| format | article |
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Methods: A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.
Results: CX reduced rebleeding to 0% (p < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD.
Conclusions: In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.</description><identifier>ISSN: 1069-6563</identifier><identifier>EISSN: 1553-2712</identifier><identifier>DOI: 10.1111/j.1553-2712.2007.00009.x</identifier><identifier>PMID: 18211317</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Animals ; Bandages ; Blood ; Blood Pressure ; Body Temperature ; CELOX ; chitosan ; Chitosan - administration & dosage ; Disease Models, Animal ; Emergency medical care ; Female ; Groin - injuries ; Hemorrhage ; Hemorrhage - drug therapy ; Hemorrhage - etiology ; hemostatic dressing ; Hemostatics - administration & dosage ; Medical procedures ; Military Medicine - instrumentation ; Powders ; Random Allocation ; Swine ; Treatment Outcome ; uncontrolled hemorrhage ; Wound healing ; Wounds and Injuries - complications ; zeolite ; Zeolites - administration & dosage</subject><ispartof>Academic emergency medicine, 2008-01, Vol.15 (1), p.74-81</ispartof><rights>2008 by the Society for Academic Emergency Medicine</rights><rights>Copyright Hanley & Belfus, Inc. Jan 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4799-8f173fad57d19fa46c1a3f3f1e45d4037dc58761ae0e4e0ebd0909b9adfb4caf3</citedby><cites>FETCH-LOGICAL-c4799-8f173fad57d19fa46c1a3f3f1e45d4037dc58761ae0e4e0ebd0909b9adfb4caf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18211317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kozen, Buddy G.</creatorcontrib><creatorcontrib>Kircher, Sara J.</creatorcontrib><creatorcontrib>Henao, Jose</creatorcontrib><creatorcontrib>Godinez, Fermin S.</creatorcontrib><creatorcontrib>Johnson, Andrew S.</creatorcontrib><title>An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot</title><title>Academic emergency medicine</title><addtitle>Acad Emerg Med</addtitle><description>Objectives: Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury.
Methods: A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.
Results: CX reduced rebleeding to 0% (p < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD.
Conclusions: In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.</description><subject>Animals</subject><subject>Bandages</subject><subject>Blood</subject><subject>Blood Pressure</subject><subject>Body Temperature</subject><subject>CELOX</subject><subject>chitosan</subject><subject>Chitosan - administration & dosage</subject><subject>Disease Models, Animal</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Groin - injuries</subject><subject>Hemorrhage</subject><subject>Hemorrhage - drug therapy</subject><subject>Hemorrhage - etiology</subject><subject>hemostatic dressing</subject><subject>Hemostatics - administration & dosage</subject><subject>Medical procedures</subject><subject>Military Medicine - instrumentation</subject><subject>Powders</subject><subject>Random Allocation</subject><subject>Swine</subject><subject>Treatment Outcome</subject><subject>uncontrolled hemorrhage</subject><subject>Wound healing</subject><subject>Wounds and Injuries - complications</subject><subject>zeolite</subject><subject>Zeolites - administration & dosage</subject><issn>1069-6563</issn><issn>1553-2712</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqNkFFLwzAYRYMobk7_ggSf15o0TdMIPow6nbAxBAXfQtom0to2s2l1-_embuirH4RcyPku5AAAMfKxm-vSx5QSL2A48AOEmI_ccH97BMa_D8cuo4h7EY3ICJxZWzqGMs5OwQjHAcYEszFYzRo4qzrVNrIrPhVcqNrYzuUM3rXK2qJ5u4GJqTeyLaxpoNEwmS_Xr9OBTEwzhbLJ4VNfvCeV6c7BiZaVVReHewJe7ufPycJbrh8ek9nSy0LGuRdrzIiWOWU55lqGUYYl0URjFdI8RITlGY1ZhKVCKnQnzRFHPOUy12mYSU0m4Grfu2nNR69sJ0rTuy9UVgQBiimKGXFQvIey1ljbKi02bVHLdicwEoNGUYrBlhhsiUGj-NEotm718tDfp7XK_xYP3hxwuwe-ikrt_l0sZsl85RL5Bs7bf4o</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Kozen, Buddy G.</creator><creator>Kircher, Sara J.</creator><creator>Henao, Jose</creator><creator>Godinez, Fermin S.</creator><creator>Johnson, Andrew S.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>200801</creationdate><title>An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot</title><author>Kozen, Buddy G. ; Kircher, Sara J. ; Henao, Jose ; Godinez, Fermin S. ; Johnson, Andrew S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4799-8f173fad57d19fa46c1a3f3f1e45d4037dc58761ae0e4e0ebd0909b9adfb4caf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Animals</topic><topic>Bandages</topic><topic>Blood</topic><topic>Blood Pressure</topic><topic>Body Temperature</topic><topic>CELOX</topic><topic>chitosan</topic><topic>Chitosan - administration & dosage</topic><topic>Disease Models, Animal</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Groin - injuries</topic><topic>Hemorrhage</topic><topic>Hemorrhage - drug therapy</topic><topic>Hemorrhage - etiology</topic><topic>hemostatic dressing</topic><topic>Hemostatics - administration & dosage</topic><topic>Medical procedures</topic><topic>Military Medicine - instrumentation</topic><topic>Powders</topic><topic>Random Allocation</topic><topic>Swine</topic><topic>Treatment Outcome</topic><topic>uncontrolled hemorrhage</topic><topic>Wound healing</topic><topic>Wounds and Injuries - complications</topic><topic>zeolite</topic><topic>Zeolites - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kozen, Buddy G.</creatorcontrib><creatorcontrib>Kircher, Sara J.</creatorcontrib><creatorcontrib>Henao, Jose</creatorcontrib><creatorcontrib>Godinez, Fermin S.</creatorcontrib><creatorcontrib>Johnson, Andrew S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Academic emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kozen, Buddy G.</au><au>Kircher, Sara J.</au><au>Henao, Jose</au><au>Godinez, Fermin S.</au><au>Johnson, Andrew S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot</atitle><jtitle>Academic emergency medicine</jtitle><addtitle>Acad Emerg Med</addtitle><date>2008-01</date><risdate>2008</risdate><volume>15</volume><issue>1</issue><spage>74</spage><epage>81</epage><pages>74-81</pages><issn>1069-6563</issn><eissn>1553-2712</eissn><abstract>Objectives: Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury.
Methods: A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.
Results: CX reduced rebleeding to 0% (p < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD.
Conclusions: In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18211317</pmid><doi>10.1111/j.1553-2712.2007.00009.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Academic emergency medicine, 2008-01, Vol.15 (1), p.74-81 |
| issn | 1069-6563 1553-2712 |
| language | eng |
| recordid | cdi_proquest_journals_220850873 |
| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Animals Bandages Blood Blood Pressure Body Temperature CELOX chitosan Chitosan - administration & dosage Disease Models, Animal Emergency medical care Female Groin - injuries Hemorrhage Hemorrhage - drug therapy Hemorrhage - etiology hemostatic dressing Hemostatics - administration & dosage Medical procedures Military Medicine - instrumentation Powders Random Allocation Swine Treatment Outcome uncontrolled hemorrhage Wound healing Wounds and Injuries - complications zeolite Zeolites - administration & dosage |
| title | An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot |
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