Al-Gahmi Al-Murtadha, Andrabi Syed Muntazir, Shahriar S M Shatil, Jara Carlos P, Xie Jingwei, Carlson Mark A
Departmentsof Surgery-General Surgery, University of Nebraska Medical Center, Omaha, NE, 68198-3280, USA.
Departmentof Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198-5965, USA.
Sci Rep. 2025 Feb 8;15(1):4679. doi: 10.1038/s41598-025-87193-3.
Uncontrolled hemorrhage, including junctional hemorrhage, is a leading cause of preventable death in military trauma. Effective therapies are urgently needed to stabilize patients and prevent further blood loss. We developed an injectable, Expandable Polyacrylamide Cryogel (EPC) that rapidly expands to tamponade bleeding. The hemostatic efficacy of EPC was compared to other hemostatic products in a porcine junctional hemorrhage model. Splenectomized domestic swine (~ 40 kg; N = 37) were randomized to no treatment (N = 8), EPC (N = 7), EPC + thrombin (N = 6), XStat (N = 7), and Combat Gauze (CG, N = 9). They underwent transection of the right femoral artery/vein, followed by 30 s of free bleed, 3 min of manual compression, and observation for up to 3 h. EPC application achieved hemostasis and 100% survival for both formulations, compared to XStat (85%), CG (67%), and no treatment (37%) (p 0.0228, Fisher exact). Mean total blood loss was lowest in EPC groups (~ 590 mL) versus no treatment (1,683 ± 570 mL), XStat (784 ± 407 mL), and CG (1,181 ± 721 mL; p < 0.001 ANOVA). All other endpoints tended to favor the EPC formulations. EPC application for junctional-type injury produced wound tamponade with better survival, reduced blood loss, and better hemodynamic and laboratory parameters compared to no treatment, with trending improvements over XStat and CG.
包括交界部位出血在内的失控性出血是军事创伤中可预防死亡的主要原因。迫切需要有效的治疗方法来稳定患者病情并防止进一步失血。我们研发了一种可注射的可膨胀聚丙烯酰胺冷冻凝胶（EPC），它能迅速膨胀以压迫止血。在猪交界部位出血模型中，将EPC的止血效果与其他止血产品进行了比较。将脾切除的家猪（约40千克；N = 37）随机分为未治疗组（N = 8）、EPC组（N = 7）、EPC + 凝血酶组（N = 6）、XStat组（N = 7）和战斗止血纱布（CG，N = 9）。它们接受右股动脉/静脉横断术，随后自由出血30秒，手动压迫3分钟，并观察长达3小时。与XStat（85%）、CG（67%）和未治疗组（37%）相比，两种EPC制剂均实现了止血且生存率达100%（p = 0.0228，Fisher精确检验）。EPC组的平均总失血量最低（约590毫升）相比未治疗组（1683±570毫升）、XStat组（784±407毫升）和CG组（1181±721毫升；p < 0.001，方差分析）。所有其他终点指标都倾向于支持EPC制剂。与未治疗相比，EPC用于交界型损伤时可实现伤口压迫，生存率更高，失血量减少，血流动力学和实验室参数更好，与XStat和CG相比也有改善趋势。
