Preferences help
enabled [disable] Abstract
Number of results
2011 | 83 | 1 | 1-9
Article title

Localized Control of Exsanguinating Arterial Hemorrhage: An Experimental Model

Title variants
Languages of publication
To develop an arterial injury model for testing hemostatic devices at well-defined high and low bleeding rates.Material and method. A side-hole arterial injury was created in the carotid artery of sheep. Shed blood was collected in a jugular venous reservoir and bleeding rate at the site of arterial injury was controlled by regulating outflow resistance from the venous reservoir. Two models were studied: uncontrolled exsanguinating hemorrhage and bleeding at controlled rates with blood return to maintain hemodynamic stability. Transcutaneous Duplex ultrasound was used to characterize ultrasound signatures at various bleeding rates.Results. A 2.5 mm arterial side-hole resulted in exsanguinating hemorrhage with an initial bleeding rate of 400 ml/min which, without resuscitation, decreased to below 100 ml/min in 5 minutes. After 17 minutes, bleeding from the injury site stopped and the animal had lost 60% of total blood volume. Reinfusion of shed blood maintained normal hemodynamics and both high and low bleeding rates could be maintained without hemorrhagic shock. Bleeding rate at the arterial injury site was held at 395±78 ml/min for 8 minutes, 110±11 ml/min for 15 minutes, and 12±1 ml/min for 12 minutes. Doppler flow signatures at the site of injury were characterized by high peak and end-diastolic flow velocities at the bleeding site which varied with the rate of hemorrhage.Conclusion. We have developed a hemodynamically stable model of acute arterial injury which can be used to evaluate diagnostic and treatment methods focused on control of the arterial injury site.
Physical description
1 - 1 - 2011
14 - 3 - 2011
  • Pusateri AE, Delgado AV, Dick EJ et al.: Application of a granular mineral-based hemostatic agent (QuikClot) to reduce blood loss after grade V liver injury in swine. J Trauma-Injury Infection and Critical Care 2004; 57: 555-562.
  • Bellamy RF: The causes of death in conventional land warfare - implications for combat casualty care research. Military Medicine 1984; 149: 55-62.13
  • Acosta JA, Yang JC, Winchell RJ et al.: Lethal injuries and time to death in a level I trauma center. J American College of Surg 1998; 186: 528-33.
  • Sauaia A, Moore FA, Moore EE et al.: Epidemiology of trauma deaths - a reassessment. J Trauma-Injury Infection and Critical Care 1995; 38: 185-93.[WoS]
  • Stewart RM, Myers JG, Dent DL et al.: Seven hundred fifty-three consecutive deaths in a level trauma center: The argument for injury prevention. J Trauma-Injury Infection and Critical Care 2003; 54: 66-70.[Crossref]
  • Carey ME: Analysis of wounds incurred by US Army Seventh Corps personnel treated in corps hospitals during Operation Desert Storm, February 20 to March 10, 1991. J Trauma-Injury Infection and Critical Care 1996; 40: S165-S169.
  • Mabry RL, Holcomb JB, Baker AM et al.: United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield. J Trauma-Injury Infection and Critical Care 2000; 49: 515-28.
  • Bellamy RF: How shall we train for combat casualty care. Military Medicine 1987; 152: 617-21.
  • Bellamy RF, ed. Combat trauma overview. Washington, DC: TMM Publication; 1995.
  • Joint Technical Coordinating Group for Mutations Effective Evaluation of Wound Data and Munitions Effectiveness in Vietnam (WDMEV). Alexandria, VA: Defense Technical Information Center 1970.
  • Sakles JC, Sena MJ, Knight DA et al.: Effect of immediate fluid resuscitation on the rate, volume, and duration of pulmonary vascular hemorrhage in a sheep model of penetrating thoracic trauma. Ann of Emergency Med 1997; 29: 392-99.
  • Holmes J: Effects of delaying fluid resuscitation on an injury to the systemic arterial vasculature. Academic Emergency Medicine 2002; 9: 267-74.
  • Oung CM, Li MS, Shumtim D et al.: In-vivo study of bleeding-time and arterial hemorrhage in hypothermic versus normothermic animals J Trauma-Injury Infection and Critical Care 1993; 35: 251-54.
  • Vaezy S, Martin R, Yaziji H et al.: Hemostasis of punctured blood vessels using high-intensity focused ultrasound. Ultrasound in Medicine and Biology 1998; 24: 903-10.[Crossref]
  • Vaezy S, Martin R, Kaczkowski P et al.: Use of high-intensity focused ultrasound to control bleeding. J Vascular Surg 1999; 29: 533-42.
  • Alam HB, Uy GB, Miller D et al.: Comparative analysis of hemostatic agents in a swine model of lethal groin injury. J of Trauma-Injury Infection and Critical Care 2003; 54: 1077-82.
  • Holcomb J, MacPhee M, Hetz S et al.: Efficacy of a dry fibrin sealant dressing for hemorrhage control after ballistic injury. Archiv of Surg 1998; 133: 32-35.
  • Holcomb JB, Pusateri AE, Harris RA et al.: Effect of dry fibrin sealant dressings versus gauze packing on blood loss in grade V liver injuries in resuscitated swine. J Trauma-Injury Infection and Critical Care 1999; 46: 49-57.
  • Jewelewicz DD, Cohn SM, Crookes BA et al.: Modified rapid deployment hemostat bandage reduces blood loss and mortality in coagulopathic pigs with severe liver injury. J Trauma-Injury Infection and Critical Care 2003; 55: 275-80.[Crossref]
  • Pusateri AE, Modrow HE, Harris RA et al.: Advanced hemostatic dressing development program: Animal model selection criteria and results of a study of nine hemostatic dressings in a model of severe large venous hemorrhage and hepatic injury in swine. J Trauma-Injury Infection and Critical Care 2003; 55: 518-26.[Crossref]
  • Sondeen JL, Coppes VG, Holcomb JB: Blood pressure at which rebleeding occurs after resuscitation in swine with aortic injury. J Trauma-Injury Infection and Critical Care 2003; 54: S110-S117.14
  • Sondeen JL, Pusateri AE, Coppes VG et al.: Comparison of 10 different hemostatic dressings in an aortic injury. J Trauma-Injury Infection and Critical Care 2003; 54: 280-85.[WoS]
  • Vournakis JN, Demcheva M, Whitson AB et al.: The RDH bandage: hemostasis and survival in a lethal aortotomy hemorrhage model. J Surgical Research 2003; 113: 1-5.
  • Hecker JF: The sheep as an experimental animal. London: Academic Press; 1983.
  • Adams DaM, M. The Sheep. ANZCCART News 1995; 8: 1-4.
  • Traber DL, Traber LB: Sheep as a cardiopulmonary model. In: Passmore JC, ed. Perspectives in Shock Research: Metabolism, Immunology, Mediators, and Models. New York: Alan R Liss; 1989: 253-263.
  • Majde JA: Animal models for hemorrhage and resuscitation research. J Trauma-Injury Infection and Critical Care 2003; 54: S100-S105.
  • Hole JW: Human anatomy and physiology. Dubuque: Wm. C. Brown Publishers; 1990.
  • Pope A, French, G, Longnecker, DE: Fluid resuscitation: state of the science for treating combat casualties and civilian injuries. Institute of Medicine Report. Washington, DC; 1999: 109-115.
  • Luo W, Zderic V, Mann FA et al.: Color and pulsed Doppler sonography for arterial bleeding detection. J Ultrasound in Medicine 2007; 26: 1019-1029.15
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.