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Comparison of Topical Hemostatic Agents in a Swine Model of Extremity Arterial Hemorrhage: BloodSTOP iX Battle Matrix vs. QuikClot Combat Gauze

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Journal Article

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USAF School of Aerospace Medicine/FH Wright-Patterson AFB United States

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BloodSTOP iX Battle Matrix BM and QuikClot Combat Gauze CG have both been used to treat traumatic bleeding. The purpose of this study was to examine the efficacy and initial safety of both products in a swine extremity arterial hemorrhage model, which mimics combat injury. Swine 37.13 0.56 kg, NBM 11, NCG 9 were anesthetized and splenectomized. We then isolated the femoral arteries and performed a 6-mm arteriotomy. After 45 s of free bleeding, either BM or CG was applied. Fluid resuscitation was provided to maintain a mean arterial pressure of 65 mmHg. Animals were observed for 3 h or until death. Fluoroscopic angiography and wound stability challenge tests were performed on survivors. Tissue samples were collected for histologic examination. Stable hemostasis was achieved in 1111 BM and 59 CG subjects, with recovery of mean arterial pressure and animal survival for 3 h p 0.05, odds ratio OR 18.82 0.85415.3. Time to stable hemostasis was shorter for the BM-treated group 4.8 2.5 min vs. 58 20.1 min median 2, interquartile range IQR 0 min vs. median 60, IQR 120 min p 0.05 and experienced longer total stable hemostasis 175.2 2.5 min vs. 92.4 29.9 min median 178, IQR 0 min vs. median 120, IQR 178 min p 0.05. Post treatment blood loss was lower with BM 9.5 2.4 mLkg, median 10.52, IQR 13.63 mLkg compared to CG 29.9 9.9 mLkg, median 29.38, IQR 62.44 mLkg p 0.2875. Standard BM products weighed less compared to CG 6.9 0.03 g vs. 20.2 0.4g p 0.05 and absorbed less blood 3.4 0.8 g vs. 41.9 12.3 g p 0.05. Fluoroscopic angiography showed recanalization in511 BM and 05 CG surviving animals p 0.07, OR 9.3 0.41208.8.

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