Self-Expanding, Tough Biodegradable Elastomers for Wound Stasis
Final rept. 1 Jul 2010-31 Mar 2014
ARSENAL MEDICAL INC WATERTOWN MA
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Noncompressible abdominal bleeding is a significant cause of preventable death on the battlefield and in the civilian setting, with no effective therapies available at point of injury. We previously reported that a self-expanding polyurethane foam significantly improved survival in a lethal hepatoportal injury model of massive venous hemorrhage. In this study, we hypothesized that foam treatment could improve survival in a lethal iliac artery injury model in noncoagulopathic swine. In swine with a closed abdomen, an iliac artery transection was created, resulting in massive noncompressible exsanguination. After injury, animals were treated with damage-control fluid resuscitation alone n 14 or foam treatment in addition to fluids. Two doses of foam treatment were studied 100 mL n 12 and 120 mL n 13 all animals were monitored for 3 hours or until death. Foam treatment at both doses resulted in a significant survival benefit and reduction in hemorrhage rate relative to the control group. Median survival time was 135 minutes and 175 minutes for the 120-mL and 100-mL doses, compared with 32 minutes in the control group p less than 0.001 for both groups. Foam resulted in an immediate, persistent improvement in mean arterial pressure and a transient increase in intra- abdominal pressure. The median hemorrhage rate was 0.27 gkg per minute in the 120-mL group and 0.23 gkg per minute in the 100-mL group, compared with 1.4 gkg per minute in the control group p0.003 and 0.006, respectively, as compared with control. Self-expanding foam treatment significantly improves survival in an otherwise lethal, noncompressible, massive, arterial injury. This treatment may provide a prehospital intervention for control of noncompressible abdominal hemorrhage.
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