Self-expanding foam for prehospital treatment of severe intra-abdominal hemorrhage

Peev, Miroslav P.; Rago, Adam P.; Hwabejire, John O.; Duggan, Michael; Beagle, John; Marini, John J.; Zugates, Greg; Busold, Rany; Freyman, Toby; Velmahos, George; DeMoya, Marc; Yeh, D. Dante; Fagenholz, Peter J.; Sharma, Upma; King, David R.

doi:10.1097/ta.0000000000000126

Cited by 37 publications

(55 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The foam material did not adhere to tissues, although in certain cases, abdominal organs were encapsulated by the material and freed manually. In addition, gross pathology of all abdominal organs after foam deployment was unremarkable except for the observation of focal, ecchymotic lesions on small and large bowel, 9,14 which would require repair or resection for long-term survival.…”

Section: Resultsmentioning

confidence: 97%

“…These results augment our previous work, where efficacy was established in a low-pressure, high-flow model of massive hepatoportal venous hemorrhage. 9,10 To test similar foam treatments in a different injury model, we selected doses for this study (100 mL and 120 mL) based on effective doses in the hepatoportal injury model. The combination of these findings supports the preclinical efficacy of foam treatment in multiple, lethal, bleeding scenarios.…”

Section: Discussionmentioning

confidence: 99%

“…9 A lethal, closed-abdomen iliac artery transection injury model 13 was tested in Sus scrofa domestica (45 T 2.7 kg). All work was conducted with Institutional Animal Care and Use Committee approval.…”

Section: Methodsmentioning

confidence: 99%

“…This model tested a low-pressure, high-flow venous bleeding scenario. 9,10 A limitation of this model, however, was high-volume crystalloid resuscitation and ventilation with 100% oxygen, 11 features inconsistent with current Tactical Combat Casualty Care (TCCC) guidelines. 12 This initial work specifically tested the durability of hemostasis under conditions known to promote bleeding.…”

mentioning

confidence: 88%

“…2 We previously investigated the dose-dependent efficacy of a self-expanding polyurethane foam in a lethal, noncompressible, Grade V hepatoportal injury model of massive venous bleeding. 9 Results suggested that foam treatment promoted survival, while the control group (fluid resuscitation alone) exsanguinated rapidly. This model tested a low-pressure, high-flow venous bleeding scenario.…”

mentioning

confidence: 96%

See 4 more Smart Citations

Self-expanding foam improves survival following a lethal, exsanguinating iliac artery injury

Rago

Duggan

Marini

et al. 2014

Journal of Trauma and Acute Care Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 88%

mentioning

confidence: 96%

See 3 more Smart Citations

Self-expanding foam improves survival following a lethal, exsanguinating iliac artery injury

Rago

Duggan

Marini

et al. 2014

Journal of Trauma and Acute Care Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Polymeric Hydrogel Systems as Emerging Biomaterial Platforms to Enable Hemostasis and Wound Healing

Pourshahrestani

Zeimaran

Kadri

et al. 2020

Adv Healthcare Materials

205

158

View full text Add to dashboard Cite

Broad interest in developing new hemostatic technologies arises from unmet needs in mitigating uncontrolled hemorrhage in emergency, surgical, and battlefield settings. Although a variety of hemostats, sealants, and adhesives are available, development of ideal hemostatic compositions that offer a range of remarkable properties including capability to effectively and immediately manage bleeding, excellent mechanical properties, biocompatibility, biodegradability, antibacterial effect, and strong tissue adhesion properties, under wet and dynamic conditions, still remains a challenge. Benefiting from tunable mechanical properties, high porosity, biocompatibility, injectability and ease of handling, polymeric hydrogels with outstanding hemostatic properties have been receiving increasing attention over the past several years. In this review, after shedding light on hemostasis and wound healing processes, the most recent progresses in hydrogel systems engineered from natural and synthetic polymers for hemostatic applications are discussed based on a comprehensive literature review. Most studies described used in vivo models with accessible and compressible wounds to assess the hemostatic performance of hydrogels. The challenges that need to be tackled to accelerate the translation of these novel hemostatic hydrogel systems to clinical practice are emphasized and future directions for research in the field are presented.

show abstract

Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding

et al. 2017

View full text Add to dashboard Cite

Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed.

show abstract

Self-expanding foam for prehospital treatment of severe intra-abdominal hemorrhage

Abstract: The self-expanding foam significantly improves survival in a dose-dependent fashion in an otherwise lethal injury. Higher doses are associated with better survival but resulted in the need for bowel resection.

Cited by 37 publications

References 15 publications

Self-expanding foam improves survival following a lethal, exsanguinating iliac artery injury

Self-expanding foam improves survival following a lethal, exsanguinating iliac artery injury

Polymeric Hydrogel Systems as Emerging Biomaterial Platforms to Enable Hemostasis and Wound Healing

Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding

Contact Info

Product

Resources

About