The concept of using the means of temporary intracavitary hemostasis at the advanced stages of medical care (literature review)

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Abstract

Helping the wounded with ongoing intra-abdominal bleeding is one of the unsolved problems of modern military field surgery. To date, there are no adequate means of temporary pre-hospital hemostasis. The paper presents the results of the analysis of modern literature covering the issues of various methods for intermitting unstopped, uncompressible abdominal bleeding at the prehospital stage. Because of the lack of clinical studies, an analysis of 22 experimental works of domestic and foreign authors was carried out. All means of intracavitary hemostasis can be divided into 3 groups: for external compression of the abdomen; to artificially increase intra-abdominal pressure; local hemostatic agents for intra-abdominal administration. The second (intraperitoneal administration of carbon dioxide and inflatable semi-compliant balloons) and the third (self-expanding polyurethane foam, heat-sensitive compositions and preparations based on poloxamer) are being especially actively investigated. Their advantages and disadvantages, limitations for use demonstrated. The conceptual provisions for the use of drugs for temporary intracavitary hemostasis in the tactical combat zone are presented.

About the authors

V. A. Reva

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Author for correspondence.
Email: vreva@mail.ru

доктор медицинских наук, подполковник медицинской службы

Russian Federation, St. Petersburg

M. S. Grishin

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: vreva@mail.ru

подполковник медицинской службы

Russian Federation, St. Petersburg

K. P. Golovko

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: vreva@mail.ru

доктор медицинских наук, доцент, полковник медицинской службы

Russian Federation, St. Petersburg

A. V. Denisov

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: denav80@mail.ru

кандидат медицинских наук, подполковник медицинской службы

Russian Federation, St. Petersburg

A. R. Medzhidova

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: denav80@mail.ru
Russian Federation, St. Petersburg

A. Ya. Kovalevsky

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: denav80@mail.ru
Russian Federation, St. Petersburg

I. M. Samokhvalov

The S.M.Kirov Military Medical Academy of Ministry of Defense of the Russian Federation

Email: igor-samokhvalov@mail.ru

заслуженный врач РФ, профессор, полковник медицинской службы в отставке

Russian Federation, St. Petersburg

References

  1. Головко К.П., Самохвалов И.М., Гришин М.С. и др. Применение местного гемостатического средства на основе хитозана для контроля внутрибрюшного кровотечения // Вестн. Рос. воен.-мед. акад. – 2022. – Т. 24, № 1. – С. 43–54.
  2. Рева В.А., Литинский М.А., Денисов А.В. и др. Первый опыт применения вспененной пенополиуретановой композиции «Локус» для остановки внутрибрюшного кровотечения при повреждении печени V степени (Экспериментальное исследование) // Воен.-мед. журн. – 2015. – Т. 336, № 4. – С. 32–39.
  3. Самохвалов И.М., Головко К.П., Пичугин А.А. и др. Возможности применения метода временного внутриполостного гемостаза при ранениях и травмах живота // Мед.-биол. и соц.-психол. пробл. безопасности в чрезвыч. ситуациях. – 2010. – № 4–1. – С. 32–38.
  4. Самохвалов И.М., Гончаров А.В., Чирский В.С. и др. «Потенциально спасаемые» раненые – резерв снижения догоспитальной летальности при ранениях и травмах // Скор. мед. помощь. – 2019. – Т. 20, № 3. – С. 10–17.
  5. Самохвалов И.М., Селезнёв А.Б., Жабин А.В. и др. Применение транексамовой кислоты для временного внутриполостного гемостаза при травме живота в эксперименте на животных // Вестн. Рос. воен.-мед. акад. – 2014. – Т. 46, № 2. – С. 97–103.
  6. Тришкин Д.В., Фисун А.Я., Крюков Е.В. и др. Военная медицина и современные войны: опыт истории и прогнозы, что ждать и к чему готовиться: Сб. тр. III Всерос. науч.-техн. конф. – Анапа, 2021. – С. 8–16.
  7. Chang J.C., Holloway B.C., Zamisch M. et al. ResQFoam for the treatment of non-compressible hemorrhage on the front line // Mil. Med. – 2015. – Vol. 180, N 9. – P. 932–933.
  8. Donaldson R.I., Zimmermann E.M., Fisher T.C. et al. Thermoreversiblereverse-phase-shift foam for treatment of noncompressible torso hemorrhage // J. Surg. Res. – 2021. – Vol. 259. – P. 175–181.
  9. Duggan M., Rago A., Sharma U. et al. Self-expanding polyurethane polymer improves survival in a model of noncompressible massive abdominal hemorrhage // J. Trauma Acute Care Surg. – 2013. – Vol. 74, N 6. – P. 1462–1467.
  10. Eastridge B.J., Mabry L.R., Seguin P. et al. Death on the battlefield (2001–2011): implications for the future of combat casualty care // J. Trauma Acute Care Surg. – 2012. – Vol. 73, N 6 (Suppl. 5). – P. S431–S437.
  11. Gruionu G., Gruionu L.G., Duggan M. et al. Feasibility of a portable abdominal insufflation device for controlling intraperitoneal bleeding after abdominal blunt trauma // Surg. Innov. – 2019. – Vol. 26, N 6. – P. 662–667.
  12. Holcomb J.B., McClain J.M., Pusateri A. E. et al. Fibrin sealant foam sprayed directly on liver injuries decreases blood loss in resuscitated rats // J. Trauma. – 2000. – Vol. 49, N 2. – P. 246–250.
  13. Kasotakis G., Duggan M., Li Y. et al. Optimal pressure of abdominal gas insufflation for bleeding control in a severe swine splenic injury model // J. Surg. Res. – 2013. – Vol. 184, N 2. – P. 931–936.
  14. Kheirabadi B.S., Tuthill D., Pearson R. et al. Metabolic and hemodynamic effects of CO2 pneumoperitoneum in a controlled hemorrhage model // J. Trauma. – 2001. – Vol. 50, N 6. – P. 1031–1043.
  15. Liu B., Ding W., Wu C. et al. Application of self-expanding polyurethane foam in the model of fatal hemorrhage // Chin. J. Emerg. Med. – 2021. – Vol. 12. – P. 526–532.
  16. McCracken B.M., Tiba M.H., Colmenero C.I. et al. Novel intraperitoneal hemostasis device prolongs survival in a swine model of noncompressible abdominal hemorrhage // J. Trauma Acute Care Surg. – 2021. – Vol. 90, N 5. – P. 838–844.
  17. Mesar T., Martin D., Lawless R. et al. Human dose confirmation for self-expanding intra-abdominal foam: A translational, adaptive, multicenter trial in recently deceased human subjects // J. Trauma Acute Care Surg. – 2015. – Vol. 79, N 1. – P. 39–46.
  18. Morrison J.J. Noncompressible torso hemorrhage // Crit. Care Clin. – 2017. – Vol. 33, N 1. – P. 37–54.
  19. Naar L., DorkenGallastegi A., Dowling M. et al. Chitosan-based lifefoam improves survival in lethal noncompressible abdominal bleeding in swine // Surg. – 2022. – Vol. 172, N 1. – P. 421–426.
  20. Peev M.P., Rago A., Hwabejire J.O. et al. Self-expanding foam for prehospital treatment of severe intra-abdominal hemorrhage: dose finding study // J. Trauma Acute Care Surg. – 2014. – Vol. 76, N 3. – P. 619–623.
  21. Pelligra R., Sandberg E.C. Control of intractable abdominal bleeding by external counterpressure // JAMA. – 1979. – Vol. 241, N 7. – P. 708–713.
  22. Rago A.P., Duggan M.J., Beagle J. et al. Self-expanding foam for prehospital treatment of intra-abdominal hemorrhage: 28-day survival and safety // J. Trauma Acute Care Surg. – 2014. – Vol. 77, N 3 (Suppl. 2). – P. S127–S133.
  23. Rago A.P., Duggan M.J., Hannett P. et al. Chronic safety assessment of hemostatic self-expanding foam: 90-day survival study and intramuscular biocompatibility // J. Trauma Acute Care Surg. – 2015. – Vol. 79, N 4 (Suppl. 2). – P. S78–S84.
  24. Rago A.P., Larentzakis A., Marini J. et al. Efficacy of a prehospital self-expanding polyurethane foam for noncompressible hemorrhage under extreme operational conditions // J. Trauma Acute Care Surg. – 2015. – Vol. 78, N 2. – P. 324–329.
  25. Rago A.P., Marini J., Duggan M.J. et al. Diagnosis and deployment of a self-expanding foam for abdominal exsanguination: translational questions for human use // J. Trauma Acute Care Surg. – 2015. – Vol. 78, N 3. – P. 607–613.
  26. Sava J., Velmahos G.C., Karaiskakis M. et al. Abdominal insufflation for prevention of exsanguination // J. Trauma Acute Care Surg. – 2003. – Vol. 54, N 3. – P. 590–594.
  27. Stannard A., Morrison J.J., Scott D.J. et al. The epidemiology of noncompressible torso hemorrhage in the wars in Iraq and Afghanistan // J. Trauma Acute Care Surg. – 2013. – Vol. 74, N 3. – P. 830–834.
  28. Velmahos G.C., Spaniolas K., Duggan M. et al. Abdominal insufflation for control of bleeding after severe splenic injury // J. Trauma Acute Care Surg. – 2007. – Vol. 63, N 2. – P. 285–290.
  29. Velmahos G.C., Spaniolas K., Tabbara M. et al. Abdominal insufflation decreases blood loss without worsening the inflammatory response: implications for prehospital control of internal bleeding // Am. Surg. – 2008. – Vol. 74, N 4. – P. 297–301.

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Copyright (c) 2023 Reva V.A., Grishin M.S., Golovko K.P., Denisov A.V., Medzhidova A.R., Kovalevsky A.Y., Samokhvalov I.M.


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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