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New Hemostatic Dressing (FAST Dressing) Reduces Blood Loss and Improves Survival in a Grade V Liver Injury Model in Noncoagulopathic Swine

De Castro, Gerard P. MD; MacPhee, Martin J. PhD; Driscoll, Ian R. MD; Beall, Dawson MS; Hsu, June MPH; Zhu, Shijun PhD; Hess, John R. MD, MPH; Scalea, Thomas M. MD; Bochicchio, Grant V. MD, MPH

Journal of Trauma-Injury Infection & Critical Care:
doi: 10.1097/TA.0b013e31821a1075
Original Article
Abstract

Background: We performed this study to evaluate the hemostatic efficacy of the FAST Dressing in treating a grade V liver injury in noncoagulopathic swine.

Methods: Sixteen female splenectomized, noncoagulopathic swine underwent reproducible grade V liver injuries. The animals were blindly randomized to two treatment groups: (1) FAST Dressing (n = 8) or (2) IgG placebo dressing (n = 8). After 30 seconds of uncontrolled hemorrhage, dressings and manual compression were applied at 4-minute intervals. The number of dressings used, time to hemostasis, total blood loss, mean arterial pressure, blood chemistry, and total resuscitation fluid volume were monitored for 2 hours after injury.

Results: The mean total blood loss was 412.5 mL (SD 201.3) for the FAST Dressing group compared with 2296.6 mL (SD 1076.0) in the placebo group (p < 0.001). All animals in the FAST Dressing group achieved hemostasis and survived for the duration of the experiment (2 hours) after injury, whereas none of the animals in the placebo group attained hemostasis or survived to 2 hours after injury (p < 0.001). The mean time to hemostasis was 6.6 minutes (SD 2.5). A median of five dressings (mean absolute deviation 1.0, p = 0.007) was sufficient to control hemorrhage in the FAST Dressing group.

Conclusion: The FAST Dressing reduced blood loss and improved survival compared with placebo in a noncoagulopathic, grade V liver injury swine model.

Author Information

From the Division of Clinical and Outcomes Research (G.P.D., I.R.D., J.H., S.Z., J.R.H., T.M.S., G.V.B.), R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland; and STB LifeSaving Technologies (M.J.M., D.B.), Rockville, Maryland.

Submitted for publication February 24, 2010.

Accepted for publication March 11, 2011.

Supported by STB LifeSaving Technologies and NIGMS T32 Research Training Grant (T32-GM075767 to G.P.D.).

Presented at the 40th Annual Meeting of the Western Trauma Association, February 28–March 6, 2010, Telluride, Colorado.

Address for reprints: Grant V. Bochicchio, MD, MPH, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 S. Greene St, Baltimore, MD 21201; email: gbochicchio@umm.edu.

© 2011 Lippincott Williams & Wilkins, Inc.