Hemorrhage is the leading cause of death from trauma. Intravenous (IV) fluid resuscitation in these patients may cause hemodilution and secondary hemorrhage. In addition, hypothermia may interfere with coagulation. The purposes of this study were to compare the effectiveness QuikClot Combat Gauze (QCG) to a control group on hemorrhage in a hemodiluted, hypothermic model, and to determine the effects of IV volume resuscitation on rebleeding. This was a prospective, between subjects, experimental design. Yorkshire swine were randomly assigned to two groups: QCG ( n=13) or control ( n=13). The subjects were anesthetized. Hypothermia (temperature of ≤34.0°C) was induced; 30% of their blood volume was exsanguinated. A 3:1 replacement of Lactated Ringer's was administered to dilute the remaining blood. The femoral artery and vein were transected. After 1min of uncontrolled hemorrhage, QCG was placed into the wound followed by standard wound packing. The control group underwent the same procedures without QCG. After 5min of manual pressure, a pressure dressing was applied. Following 30min, the dressings were removed, and blood loss was calculated. For subjects achieving hemostasis, up to 5L of IV fluid was administered or until bleeding occurred, which was defined as >2% total blood volume. The QCG had significantly less hemorrhage than the control (QCG=30±99mL; control=404±406mL) ( p= 004). Further, the QCG group was able to tolerate more resuscitation fluid before hemorrhage (QCG=4615±1386mL; control=846±1836) ( p= 000).
- Hemorrhage control
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