Document Detail


A large animal fatal extremity hemorrhage model and evaluation of a polymeric dressing (fatal extremity hemorrhage).
MedLine Citation:
PMID:  17099515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Extremity hemorrhage is a contributor to preventable battlefield mortality. The Army has liberalized tourniquet use guidelines in an attempt to prevent these deaths. To evaluate wound hemostatic agents that might allow for early tourniquet removal while maintaining hemorrhage control, a model of lethal extremity hemorrhage in the goat (Capra hircus) was developed and a polymeric dressing agent (BioFoam) tested. METHODS: After administration of a spinal block, animals were placed in lateral recumbancy with a head-up tilt of 6 degrees, 500 mL crystalloid was injected and 600 u/Kg of heparin was administered. After tourniquet application to the thigh, a soft tissue and vascular injury was created by transecting muscles and the femoral artery. The polymeric wound dressing was applied and the tourniquet was released. RESULTS: In testing, the primary endpoint was mortality within the first hour after tourniquet release. None of the control animals survived the full hour. Two out of five (40%) of the treated animals survived. With survivors' survival time calculated as 60 minutes, survival time was found not to differ between treated (34 +/- 19 minutes) and untreated (29 +/- 18 minutes) animals (p = 0.77). CONCLUSION: The physical characteristics of tissue injury, need for anticoagulation, and manipulation of blood pressure are vital factors contributing to the lethality of a large animal fatal extremity hemorrhage model. BioFoam was successful in preventing fatal arterial extremity hemorrhage after the release of an effective tourniquet in some cases. An agent that can reliably allow for safe tourniquet removal and restoration of collateral circulation is a potential solution to tourniquet-associated morbidity in traumatic extremity injury. The model developed will serve as a rigorous test for such agents.
Authors:
Thomas Walters; David G Baer; David S Kauvar
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of trauma     Volume:  61     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-13     Completed Date:  2006-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1107-12     Citation Subset:  AIM; IM    
Affiliation:
US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6315, USA. thomas.walters@amedd.army.mil
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MeSH Terms
Descriptor/Qualifier:
Animals
Anticoagulants / administration & dosage*
Bandages*
Disease Models, Animal
Goats
Hemostasis / drug effects
Hemostatic Techniques / instrumentation*
Male
Polymers
Tourniquets
Wounds and Injuries / mortality,  therapy*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Polymers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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