Hemostatic effects of Microporous Polysaccharide Hemosphere® in a rat model with severe femoral artery bleeding

Abstract

An appropriate hemostatic dressing for prehospital use should lower mortality due to uncontrolled hemorrhage. In this study, the investigators explored the hemostatic effects of Microporous Polysaccharide Hemosphere (MPH) applied in a rat model with severe femoral artery bleeding. Twelve rats were randomly assigned to MPH and control groups: The femoral artery of each rat was pierced to initiate bleeding. Then, 0.25 g MPH was poured into the bleeding site. A 200-g scale weight was placed over the bleeding site for 30 sec. At 30-sec intervals, the scale weight was removed, and hemostasis was assessed visually. After 30 sec, if the bleeding had ceased, the test was scored and checked as "passed at 30 sec." If the bleeding had not stopped, the same procedures were repeated a maximum of 3 times. If hemostasis could not be achieved even after the third application, the test was scored as failed. The same sequence of procedures was repeated for the control group without use of MPH and with only standard compression. Application of MPH resulted in complete control of bleeding in 2 of 6, 4 of 6, and 6 of 6 rats at 30, 60, and 90 sec, respectively. In the control group, however, hemostasis could not be achieved in all 6 rats, even at 90 sec. The difference between the 2 groups was statistically significant (P=.007). Application of MPH and compression with a scale weight significantly decreased the time of hemostasis in the rat model with femoral arterial bleeding.

Hemostatic Efficacy of Local “Chitosan Linear Polymer” Granule in an Experimental Sheep Model with Severe Bleeding of Arteria and Vena Femoralis

“…[2,3,7,[18][19][20] While many local hemostatic agents have been tested, no clear consensus exists regarding optimal hemorrhage control strategy for external bleeding. [1,4,8,9,[13][14][15][16][17]20,[24][25][26][27][28][29][30] However, Pusateri and Grissom [10,19] outlined ideal qualities of hemostatic agents for prehospital and battlefield use.…”

“…Recognizing the potential limited access to additional product in emergency evacuation situations, it was likewise important that the product could be re-applied if bleeding recurred. [1,3,13,15,16,[21][22][23][24][25][26][27][28][31][32][33] While some reports on human use have been published, live tissue studies and animal trials have been highly encouraging. Chitosan linear polymer has a long shelf life and requires no special assembly (or mixing of components) at the time of application.…”

“…[1,10,15] The design implemented was unblinded and randomized, with an accepted swine groin injury model (though juvenile sheep were used). The efficacy of 2 treatments for surgically created, lethal, groin arterial and venous bleeding injury were tested.…”

“…In response, hemostasis research has been a major emphasis of cooperative efforts by military and civilian trauma researchers of different countries. [1,6,7] The need for hemostatic agents is greater in the event of large-scale disaster such as terrorist attack, bombing, or devastating earthquake, though in such austere conditions, proper hemostasis of all those wounded is often impossible to achieve. [1][2][3][4][5][8][9][10][11][14][15][16]18,20] The aim of the present study was to test the hemostatic effect of chitosan linear polymer and compression, compared with standard gauze dressing and compression in an experimental young sheep model with severe bleeding of femoral artery and vein.…”

“…Rapid hemostasis is essential as a strategy, not only for initial survival, but also for optimal recovery. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] A recent review of autopsies of 982 combat deaths from Iraq and Afghanistan revealed that nearly 24% could have been prevented with effective treatment. Of those potentially preventable deaths, 85% occurred as a result of hemorrhage, 1/3 of which were compressible, 2/3 of which were not, em-…”