Rothwell Stephen W, Reid Thomas J, Dorsey Jennifer, Flournoy William S, Bodo Michael, Janmey Paul A, Sawyer Evelyn
Department of Blood Research, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910-7500, USA.
J Trauma. 2005 Jul;59(1):143-9. doi: 10.1097/01.ta.0000171528.43746.53.
Recently, a wide variety of bandages have been formulated to attempt to improve the effectiveness of emergency intervention in situations of uncontrolled bleeding. The best of these dressings contain a mixture of human thrombin and fibrinogen. The presence of human components in these bandages, although effective, increases the cost of the dressing and raises questions of availability of raw materials and transmission of pathogens. The purpose of this study was to investigate the efficacy of dressings composed of salmon thrombin and fibrinogen in a swine aortotomy model.
A 4.4-mm aortotomy was produced in the abdominal aorta of 19 anesthetized, splenectomized swine. The United States Army standard field gauze was applied to 8 animals, and the salmon thrombin-fibrin dressing (SFD) was applied to 11 animals. Survival, blood loss, and other parameters were measured over a 60-minute period.
All 11 animals that received the SFD survived the aortotomy injury, and bleeding stopped within 7.5 +/- 1.5 min. Seven of 8 animals in the control group were killed when bleeding continued and blood pressures decreased to the cutoff values as outlined in the animal protocol. Bleeding was significantly less in the SFD group compared with the gauze group (241 +/- 65.3 vs. 932.7 +/- 142.4 mL).
Fibrin dressing using salmon-derived thrombin and fibrinogen is effective in controlling severe, uncontrolled bleeding. This dressing may offer an alternative to dressings composed of human coagulation proteins.
最近，人们研发了各种各样的绷带，试图提高在无法控制出血情况下的紧急干预效果。这些绷带中最好的含有人类凝血酶和纤维蛋白原的混合物。这些绷带中存在人类成分，虽然有效，但增加了绷带的成本，并引发了原材料供应和病原体传播的问题。本研究的目的是在猪主动脉切开术模型中研究由鲑鱼凝血酶和纤维蛋白原组成的绷带的疗效。
在19只麻醉、脾切除的猪的腹主动脉上制作一个4.4毫米的主动脉切口。将美国陆军标准野战纱布应用于8只动物，将鲑鱼凝血酶-纤维蛋白绷带（SFD）应用于11只动物。在60分钟内测量存活率、失血量和其他参数。
所有11只接受SFD的动物在主动脉切开术损伤后存活，出血在7.5±1.5分钟内停止。对照组的8只动物中有7只因出血持续且血压降至动物实验方案中规定的临界值而死亡。与纱布组相比，SFD组的出血量明显更少（241±65.3 vs. 932.7±142.4毫升）。
使用鲑鱼来源的凝血酶和纤维蛋白原的纤维蛋白绷带在控制严重的、无法控制的出血方面是有效的。这种绷带可能为含有人类凝血蛋白的绷带提供一种替代方案。
