Exothermic reaction in zeolite hemostatic dressings: QuikClot ACS and ACS+.

Abstract

BACKGROUND:

Zeolites have hemostatic properties used to stop bleeding in severe hemorrhage. Manufactured QuikClot is an approved zeolite-based hemostatic agent for battlefield use. The exothermic reaction associated with QuikClot as loose granules or as granules packaged in a mesh bag has potential burn effects; this led to the development of a formulation of "cooler" non-exothermic QuikClot. The goal of this study was to compare the elevation of temperature of these formulations upon contact with blood.

METHODS:

Following full transection of the femoral vasculature, anesthetized Yorkshire pigs (n = 15) (28.8 +/- 1.5 kg) were hemorrhaged for 2 min and treated with 100 g of bagged QuikClot (Advanced Clotting Sponge (ACS) (n = 4)) or a modified non-exothermic formulation (ACS+ (n = 11)). Vital signs and temperature at the dressing/tissue interface were continuously recorded for 3 h. Additional procedures were used to examine effects of different ratios of blood to zeolite on temperature elevation.

RESULTS:

Total post-treatment blood loss was comparable for ACS+_E and ACS_E groups (overall average: 18.6 +/- 10.5% EBV). Temperature recorded at the dressing/tissue interface was significantly lower with ACS+ vs. ACS (40.3 +/- 1.8 vs. 61.4 +/- 10.7 degrees C, respectively, p < 0.01) and was 3.2 +/- 2.6 degrees C higher than rectal temperature (38.0 +/- 0.7 degrees C, p < 0.01). Survival at endpoint (7/11 vs. 4/4) and average survival time (134 +/- 64 vs. 180 min) were greater for both ACS+ and ACS in comparison to Standard Dressing. The wound temperature with ACS was reduced with greater blood to product ratios and this pattern was paralleled with in vitro measurements.

CONCLUSIONS:

The lower heat release with ACS+ compared to ACS was confirmed in an animal model and ACS+ had similar efficacy in arresting bleeding when compared to Standard Dressing.

• Authors: Françoise Arnaud, Toshiki Tomori, Walter Carr, Anne McKeague, Kohsuke Teranishi, Keith Prusaczyk, Richard McCarron
• Journal: Annals of biomedical engineering (Ann Biomed Eng) Vol. 36 Issue 10 Pg. 1708-13 (Oct 2008) ISSN: 1573-9686 [Electronic] United States
• PMID: 18712606 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hemostatics
• Zeolites

Topics

• Animals
• Bandages
• Blood Coagulation (drug effects)
• Body Temperature (drug effects)
• Burns, Chemical (prevention & control)
• Hemorrhage (drug therapy)
• Hemostatics (adverse effects, therapeutic use)
• Hot Temperature
• Swine
• Wounds, Penetrating (drug therapy)
• Zeolites (adverse effects, therapeutic use)