Evaluation der Blutgerinnung verschiedener Großtiermodelle und Vergleich des prokoagulatorischen Effektes der Hämostyptika QuikClot® Gauze TM, Celox TM Gauze, QuikClot ACS+ TM und H&H PriMed Compressed Gauze mit der Rotationsthromboelastometrie

Abstract

Introduction: Haemorrhage is the leading cause of preventable death in military conflicts. Different types of haemostatic dressings have been developed and have been compared in animal studies for their ability to control bleeding. The effects of haemostatic agents in animals may be different from those in humans. It is still unclear what animal species is most similar to humans in terms of the physiology of blood coagulation. In addition, there is a paucity of data comparing the effects of different haemostatic dressings in humans. Material and methods: Rotational thromboelastometry (ROTEM) was used to analyse coagulation in various animal species (pigs, sheep, rabbits, and dogs) and to compare it with human coagulation. In addition, ROTEM was used to examine the efficacy of different haemostatic dressings (QuikClot® Gauze TM, Celox TM Gauze and QuikClot ACS+ TM) in comparison to standard gauze in human blood. Results: All animal species showed differences in coagulation properties when compared to humans. Dogs and sheep were most similar to humans in terms of coagulation. QuikClot® Gauze TM was the most efficacious haemostatic dressing, followed by Celox TM Gauze and standard gauze. QuikClot ACS+ TM was clearly outperformed by all other dressings. Conclusion: Our results suggest that dogs and sheep should be preferred to pigs or rabbits in haemostatic research. Furthermore modern haemostatic dressings such as QuikClot® Gauze TM and Celox TM Gauze should be preferred to previous generations of haemostatic dressings such as QuikClot ACS+ TM. In-vitro studies like rotational thromboelastometry can provide valuable information about the mechanisms of action of haemostatic dressings. A combination of different mechanisms of action may increase the efficacy of haemostatic dressings.