| High-pressure fibrin sealant foam: an effective hemostatic agent for treating severe parenchymal hemorrhage. | |
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MedLine Citation:
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PMID: 17583744 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The majority of early trauma deaths are related to uncontrolled, noncompressible, parenchymal hemorrhage from truncal injuries. The purpose of this study was to formulate a fibrin sealant foam (FSF) able to control severe parenchymal bleeding without compression or vascular control. MATERIALS AND METHODS: FSF with high fibrinogen concentration (20 mg/mL) and low thrombin activity (5 U/mL) was prepared and pressurized by addition of liquid gas propellant. The efficacy of this foam was tested against a severe parenchymal hemorrhage, created by partial resection of liver lobes in anticoagulated rabbits (n = 7) and compared to untreated injury (n = 8) and placebo treatment (n = 7). The hemostatic efficacy of pressurized FSF (n = 8) was also compared to a commercially available liquid fibrin sealant (n = 8) and a developing dry powdered fibrin sealant product (n = 8) in the same model. RESULTS: The liver injury resulted in 122 +/- 11.5 mL blood loss and death of 75% of untreated rabbits (3.2-3.4 kg) within 1 h. Treatment with placebo foam had no effect on blood loss or mortality rate. Pressurized FSF significantly reduced bleeding, resulting in 56% (P < 0.05) and 66% (P < 0.01) reduction in blood loss as compared to untreated or placebo-treated animals, respectively, and 100% survival (P = 0.008). When pressurized FSF was compared with liquid and powdered forms of fibrin sealant, only foam significantly reduced blood loss (49%, P < 0.05) and mortality rate (54%, P < 0.05) of rabbits as compared to untreated control animals (n = 9). CONCLUSION: Biological nature, rapid preparation, coverage of large wound areas, and effective hemostatic properties make pressurized FSF an ideal candidate for treating nonoperable parenchymal injuries in damage control procedures. |
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Authors:
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Bijan S Kheirabadi; Jennifer Sieber; Tallat Bukhari; Kiti Rudnicka; Lara A Murcin; David Tuthill |
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Publication Detail:
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Type: Journal Article Date: 2007-06-20 |
Journal Detail:
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Title: The Journal of surgical research Volume: 144 ISSN: 0022-4804 ISO Abbreviation: J. Surg. Res. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-17 Completed Date: 2008-02-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: United States |
Other Details:
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Languages: eng Pagination: 145-50 Citation Subset: IM |
Affiliation:
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US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA. Bijan.Kheirabadi@CEN.AMEDD.ARMY.MIL |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Bandages* Blood Pressure Disease Models, Animal Fibrin Foam / pharmacology* Fibrin Tissue Adhesive / pharmacology* Hemorrhage / mortality, therapy* Hemostatics / pharmacology* Humans Kaplan-Meiers Estimate Liver / blood supply, injuries*, surgery Male Pressure Rabbits Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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0/Fibrin Foam; 0/Fibrin Tissue Adhesive; 0/Hemostatics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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