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Titolo:
FIBRIN GLUE TERMINATES MASSIVE BLEEDING AFTER COMPLEX HEPATIC-INJURY
Autore:
COHN SM; CROSS JH; IVY ME; FEINSTEIN AJ; SAMOTOWKA MA;
Indirizzi:
UNIV MIAMI,SCH MED,DEPT SURG,DIV TRAUMA & SURG CRIT CARE,POB 016960 D40 MIAMI FL 33101 YALE UNIV,SCH MED,DEPT SURG NEW HAVEN CT 06510
Titolo Testata:
The journal of trauma, injury, infection, and critical care
fascicolo: 4, volume: 45, anno: 1998,
pagine: 666 - 670
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; SPLENIC TRAUMA; HEMOSTASIS; COLLAGEN; PLASMA;
Keywords:
FIBRIN GLUE; LIVER INJURY; ABBREVIATED LAPAROTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
S.M. Cohn et al., "FIBRIN GLUE TERMINATES MASSIVE BLEEDING AFTER COMPLEX HEPATIC-INJURY", The journal of trauma, injury, infection, and critical care, 45(4), 1998, pp. 666-670

Abstract

Objective: We determined the ability of a packaged fibrin glue (FG) product to terminate severe bleeding in a new porcine model of complex hepatic injury. Methods: Femoral arterial and venous catheters were placed in pentobarbital-anesthetized swine (n = 7 per group, 16-18 kg), Pigs received an external blast to the right upper abdomen at 0 minutes, followed by uncontrolled hemorrhage at 0 to 30 minutes, with anticoagulation (heparin, 200 U/kg) at 10 minutes. Pigs were resuscitated with lactated Ringer's solution (20 mL/kg) beginning at 15 minutes and then underwent laparotomy to control bleeding at 30 minutes. Lactated Ringer's solution was infused to keep mean arterial pressure greater than 70 mm Hg until 120 minutes, when repeat laparotomy was performed. Control animals (group I) underwent routine surgical procedures to terminate bleeding followed by packing if hepatic bleeding continued. The FG animals (group II) underwent routine surgical procedures plus application of FG, Avoidance of packing, estimated blood loss (EBL) during and after laparotomy, and fluid resuscitation volume were the primary end points studied. Results: In both groups, mean arterial pressure varied significantly from baseline to 120 minutes (group I: 100 +/- 3 to52 +/- 11 mm Hg; group II: 99 +/- 4 to 66 rt 3 mm Hg). Temperature decreased at the end of each experiment (group I: 37 +/- 1 to 33 +/- 1 degrees C; group II: 37 +/- 1 to 34 +/- 1 degrees C). There were no group differences in EEL before laparotomy (0-30 minutes), but from initial laparotomy to repeat laparotomy (30-120 min), EEL (group I: 875 +/-265 mL; group II: 300 +/- 59 mL) and total fluid resuscitation (groupI: 2.9 +/- 0.4 L; group II: 1.9 +/- 0.3 L) were statistically significantly less in PG pigs, Of greatest importance, six of seven control pigs required packing, but none of the FG animals were parked and none bled at repeat laparotomy. Conclusion: FG stopped bleeding and eliminated the need for packing in a model of severe liver injury. Further work in the clinical arena is warranted to determine the potential benefits of FG in arresting hemorrhage in hypotensive, hypothermic, coagulopathic trauma patients with complex visceral injuries.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 19:17:10