Retrohepatic Vena Cava (RIVC) Injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Z-Medica, Control + ®) would improve hemorrhage control from a penetrating RIVC injury compared to packing with standard laparotomy sponges alone.
Twelve male Yorkshire pigs received a 25% exchange transfusion of blood for refrigerated normal saline to induce a hypothermic coagulopathy. A laparotomy was performed and a standardized 1.5cm injury to the RIVC was created which was followed by temporary abdominal closure and a period of uncontrolled hemorrhage. When the mean arterial pressure reached 70% of baseline, demonstrating hemorrhagic shock, the abdomen was re-entered and the injury was treated with perihepatic packing using standard laparotomy sponges (L; n=6) or a new kaolin-based hemostatic dressing (K; n=6). Animals were then resuscitated for 6 hours with crystalloid solution. The two groups were compared using the Wilcoxon rank sum test and Fisher exact test. A p≤0.05 was considered statistically significant.
There was no difference in the animal's temperature, heart rate, mean arterial pressure, cardiac output, and blood loss at baseline or before packing was performed (all p>0.05). In the laparotomy sponge group, 5 of 6 pigs survived the entire study period while all 6 pigs treated with kaolin-based D2 hemostatic dressings survived. Importantly, there was significantly less blood loss after packing with the new hemostatic kaolin-based dressing compared to packing with laparotomy sponge (651mL±180 vs 1073mL±342; p≤0.05).
These results demonstrate that the use of this new hemostatic kaolin-based dressing improved hemorrhage control and significantly decreased blood loss in this penetrating RIVC model.
Level V. This is basic science research based on a large animal model.
This research output has an Altmetric Attention Score of 67. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2020.
All research outputs
#814,375
of 34,400,738 outputs
Outputs from Journal of Trauma and Acute Care Surgery, The
#91
of 5,304 outputs
Outputs of similar age
#12,574
of 360,312 outputs
Outputs of similar age from Journal of Trauma and Acute Care Surgery, The
#4
of 95 outputs
Altmetric has tracked 34,400,738 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,304 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.2. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 360,312 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 95 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.
