Hemorrhage control in the battlefield: role of new hemostatic agents.

Uncontrolled hemorrhage is the leading cause of preventable combat-related deaths. The vast majority of these deaths occur in the field before the injured can be transported to a treatment facility. Early control of hemorrhage remains the most effective strategy for treating combat casualties. A number of hemostatic agents have recently been deployed to the warfront that can be used to arrest bleeding before surgical control of the source. The purpose of this article is to summarize the background information regarding these hemostatic agents, indications and rationale for their use, and characteristics of these products that may impact effectiveness.

[1]  Joshua S Vayer,et al.  Hemostatic dressings for the first responder: a review. , 2004, Military medicine.

[2]  Peter Rhee,et al.  Application of a zeolite hemostatic agent achieves 100% survival in a lethal model of complex groin injury in Swine. , 2004, The Journal of trauma.

[3]  Richard A. Harris,et al.  Advanced hemostatic dressing development program: animal model selection criteria and results of a study of nine hemostatic dressings in a model of severe large venous hemorrhage and hepatic injury in Swine. , 2003, The Journal of trauma.

[4]  K. Proctor,et al.  Modified rapid deployment hemostat bandage reduces blood loss and mortality in coagulopathic pigs with severe liver injury. , 2003, The Journal of trauma.

[5]  Peter Rhee,et al.  Comparative analysis of hemostatic agents in a swine model of lethal groin injury. , 2003, The Journal of trauma.

[6]  Harlan Ullman,et al.  War in Iraq , 2003 .

[7]  Peter Rhee,et al.  Battlefield casualties treated at Camp Rhino, Afghanistan: lessons learned. , 2003, The Journal of trauma.

[8]  J. Holcomb,et al.  Comparison of 10 different hemostatic dressings in an aortic injury. , 2003, The Journal of trauma.

[9]  J. Anema,et al.  Treatment of grade 4 renal stab wounds with absorbable fibrin adhesive bandage in a porcine model. , 2001, The Journal of urology.

[10]  A. Baker,et al.  United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield. , 2000, The Journal of trauma.

[11]  S. Schwaitzberg,et al.  Comparison of poly-N-acetyl glucosamine (P-GlcNAc) with absorbable collagen (Actifoam), and fibrin sealant (Bolheal) for achieving hemostasis in a swine model of splenic hemorrhage. , 2000, The Journal of trauma.

[12]  S. Schwaitzberg,et al.  A pilot study evaluating the efficacy of a fully acetylated poly-N-acetyl glucosamine membrane formulation as a topical hemostatic agent. , 1999, Surgery.

[13]  J. Holcomb,et al.  Dry fibrin sealant dressings reduce blood loss, resuscitation volume, and improve survival in hypothermic coagulopathic swine with grade V liver injuries. , 1999, The Journal of trauma.

[14]  J. Holcomb,et al.  Effect of dry fibrin sealant dressings versus gauze packing on blood loss in grade V liver injuries in resuscitated swine. , 1998, The Journal of trauma.

[15]  J. R. Groves,et al.  Operations in Urban Environments , 1998 .

[16]  J. Holcomb,et al.  Implications of new dry fibrin sealant technology for trauma surgery. , 1997, The Surgical clinics of North America.

[17]  M. Carey,et al.  Analysis of wounds incurred by U.S. Army Seventh Corps personnel treated in Corps hospitals during Operation Desert Storm, February 20 to March 10, 1991. , 1996, The Journal of trauma.

[18]  D. Lew,et al.  Effect of chitosan on lingual hemostasis in rabbits. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[19]  M. Kerstein.  How shall we train for combat casualty care. , 1988, Military medicine.

[20]  R. Shuman,et al.  Chitosan: a new topical hemostatic agent for diffuse capillary bleeding in brain tissue. , 1984, Neurosurgery.

[21]  R. Bellamy.  The causes of death in conventional land warfare: implications for combat casualty care research. , 1984, Military medicine.

[22]  H. Orita,et al.  The hemostatic effect of deacetylated chitin membrane on peritoneal injury in rabbit model , 2004, Surgery Today.

[23]  P. Rhee,et al.  Intracorporeal use of the hemostatic agent QuickClot in a coagulopathic patient with combined thoracoabdominal penetrating trauma. , 2004, The Journal of trauma.

[24]  Richard A. Harris,et al.  Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine. , 2003, The Journal of trauma.

[25]  A. Pope,et al.  COMMITTEE ON FLUID RESUSCITATION FOR COMBAT CASUALTIES , 1999 .

[26]  A. Pope,et al.  Fluid Resuscitation: State of the Science for Treating Combat Casualties and Civilian Injuries , 1999 .

[27]  J. Holcomb,et al.  Efficacy of a dry fibrin sealant dressing for hemorrhage control after ballistic injury. , 1998, Archives of surgery.

[28]  M. Carey.  An Analysis of U.S. Army Combat Mortality and Morbidity Data , 1988 .