| Acute in-vivo evaluation of bleeding with Gelfoam plus saline and Gelfoam plus human thrombin using a liver square lesion model in swine. | |
| | |
MedLine Citation:
|
PMID: 18629446 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Management of post-operative bleeding has historically used topical bovine thrombin. However, possible harm through activation of coagulation inhibitors has encouraged investigation with other hemostatic agents. This study utilized a novel ordinal bleeding model to test whether a Gelfoam + human thrombin solution is superior at controlling bleeding when compared to Gelfoam + saline solution at different time intervals. STUDY DESIGN: Four swine underwent open laparotomy after receiving unfractionated heparin. Twenty open liver biopsies were performed in each swine; ten biopsies treated with Gelfoam + human thrombin solution and 10 biopsies treated with Gelfoam + saline solution. Three, 6 min, and 12 min after the procedure, bleeding was objectively graded by a four-point model. RESULTS: There was a significant (P < 0.017), treatment effect on each success/failure outcome (success = bleeding score <or= 1; failure = bleeding score > 1) at 3 (P < 0.001), 6 (P < 0.001), and 12 (P = 0.003) min, based on a 2 x 2 Fisher's exact test. Similarly, there was a significant treatment effect on each success/failure outcome and four-point bleeding score based on a multiple logistic regression analysis controlling for pig, lesion weight, and initial bleeding taking into consideration repeated measures at three time points. CONCLUSIONS: The results demonstrate a superior treatment effect for control of bleeding using human thrombin compared to a saline solution. Future studies should compare bovine thrombin versus human thrombins ability to control bleeding as well as the hazard of each in activating coagulation inhibitors. |
| | |
Authors:
|
George L Adams; Roberto J Manson; Vic Hasselblad; Linda K Shaw; Jeffrey H Lawson |
Related Documents
:
|
17429206 - Antiplatelet therapy and the risk of bleeding induced by gastrointestinal endoscopic pr... 7993246 - Bronchial artery embolization to control haemoptysis. 1727266 - A comparison of conventional and low-bleed implants in augmentation mammaplasty. 11136956 - Early administration of vapreotide for variceal bleeding in patients with cirrhosis. 14769716 - Potassium supplementation, diet vs pills: a randomized trial in postoperative cardiac s... 10750776 - Modification of the subclavian patch aortoplasty for repair of aortic coarctation in ne... |
Publication Detail:
|
Type: Journal Article Date: 2008-07-16 |
Journal Detail:
|
Title: Journal of thrombosis and thrombolysis Volume: 28 ISSN: 1573-742X ISO Abbreviation: J. Thromb. Thrombolysis Publication Date: 2009 Jul |
Date Detail:
|
Created Date: 2009-06-10 Completed Date: 2009-08-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9502018 Medline TA: J Thromb Thrombolysis Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 1-5 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Blood Loss, Surgical / prevention & control* Cattle Gelatin Sponge, Absorbable / pharmacology* Hemorrhage / drug therapy* Humans Liver / surgery* Models, Biological Sodium Chloride / pharmacology* Swine Thrombin / pharmacology* |
| Chemical | |
Reg. No./Substance:
|
7647-14-5/Sodium Chloride; EC 3.4.21.5/Thrombin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Dependency of phenprocoumon dosage on polymorphisms in the VKORC1 and CYP2C9 genes.
Next Document: Autoimmunity in the immune privileged eye: pathogenic and regulatory T cells.