A novel biologic hemostatic dressing (fibrin patch) reduces blood loss and resuscitation volume and improves survival in hypothermic, coagulopathic Swine with grade V liver injury
Abstract
This study evaluated the efficacy of a biologic hemostatic fibrin patch (FP) to control coagulopathic bleeding and prevent death in a porcine model of severe liver injury with hemodilution and hypothermia. Coagulopathy was produced in swine by exchanging 60% of the animals' circulating blood volume with Hextend and lowering the core temperature to 32.0 degrees C +/- 0.5 degrees C. A grade V liver injury was induced and allowed to bleed freely for 30 seconds (pretreatment blood loss). Animals were randomly divided into three treatment groups: hepatic packing (HP) using laparotomy sponges, FP application plus HP, or placebo patch (PP) application plus HP. Animals were resuscitated to 80% of the preinjury mean arterial pressure. Core temperature, mean arterial pressure, and survival were monitored for 1 hour postinjury. Packs were removed from the animals that survived to 1 hour and they were monitored for an additional hour. Coagulopathy was confirmed by significant increases (p < 0.01) in prothrombin time, activated partial thromboplastin time, and activated clotting time in preinjury measurements as compared with baseline values. Pretreatment blood loss was not different among the groups. However, significant (p < 0.01) differe...Continue Reading
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