Comparison of a new mineral based hemostatic agent to a commercially available granular zeolite agent for hemostasis in a swine model of lethal extremity arterial hemorrhage

Background: Gaining hemostatic control of vascular injuries sustained in combat using topical agents remains a challenge. We previously developed a new hemostatic agent consisting of a granular combination of a smectite mineral and a superabsorbent polymer (WoundStat (TM); WS) which demonstrated the ability to stop high pressure bleeding. We have since modified WS to contain only the smectite mineral and compared the performance of WS to QuikClot's (TM) zeolite granules (QCG) in a lethal vascular injury model. Methods: Fourteen (seven per group) anesthetized swine (35-44 kg) had a lethal femoral artery injury produced by creating a 6 mm arteriotomy in the vessel. After 45 s of hemorrhage, animals were randomized to be treated with either WS or QCG for 3 min. A second application was provided if hemostasis failed. Fluid resuscitation was begun at the time of application to achieve a mean arterial blood pressure of 65 mmHg. Animals were observed for 120 min or until death. Primary endpoints were survival, survival time, post-treatment blood loss, and resuscitation fluid volume. Results: WS resulted in 100% survival to 120 min. No animal in the QCG group survived (p=0.0005). Survival times for WS animals were significantly greater compared to QCG (p=0.0001). Post-treatment blood loss (p=0.0043) and post-resuscitation fluid volume (p=0.0043) was significantly less for animals treated with WS compared to QCG. Conclusion: WS consisting of just the smectite mineral was superior to QCG tested in this model. Additional study is warranted to determine its potential for use in combat and civilian trauma. (C) 2008 Published by Elsevier Ireland Ltd.