Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine

J Trauma. 2003 Jan;54(1):177-82. doi: 10.1097/00005373-200301000-00023.

Abstract

Background: Hemorrhage is a leading cause of death from trauma. An advanced hemostatic dressing could augment available hemostatic methods. We studied the effects of a new chitosan dressing on blood loss, survival, and fluid use after severe hepatic injury in swine.

Methods: Swine received chitosan dressings or gauze sponges. Standardized, severe liver injuries were induced. After 30 seconds, dressings were applied and resuscitation initiated. Blood loss, hemostasis, resuscitation volume, and 60-minute survival were quantified.

Results: Posttreatment blood loss was reduced ( p< 0.01) in the chitosan group (264 mL; 95% confidence interval [CI], 82-852 mL) compared with the gauze group (2,879 mL; 95% CI, 788-10,513 mL). Fluid use was reduced ( p= 0.03) in the chitosan group (1,793 mL; 95% CI, 749-4,291) compared with the gauze group (6,614 mL; 95% CI, 2,519-17,363 mL). Survival was seven of eight and two of even in the chitosan and gauze groups ( p= 0.04), respectively. Hemostasis was improved in the chitosan group ( p= 0.03).

Conclusion: A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Bandages / standards*
  • Blood Volume
  • Chitin / analogs & derivatives*
  • Chitin / therapeutic use*
  • Chitosan
  • Disease Models, Animal*
  • Drug Evaluation, Preclinical
  • Female
  • Fluid Therapy / methods
  • Hemorrhage / diagnosis
  • Hemorrhage / etiology
  • Hemorrhage / mortality
  • Hemorrhage / therapy*
  • Hemostatic Techniques / standards*
  • Hemostatics / therapeutic use*
  • Liver / injuries*
  • Male
  • Random Allocation
  • Resuscitation / methods
  • Survival Analysis
  • Swine
  • Time Factors

Substances

  • Hemostatics
  • Chitin
  • Chitosan