Assessment of topical hemostats in a renal hemorrhage model in heparinizedrats

Various topical hemostatic agents or devices have been employed to address the challenges associated with hemorrhage from parenchymal organs during su rgery or trauma. Their relative efficacy, however, has not been assessed in a single animal model. The objective of this study was to develop a small animal renal hemorrhage model for comparing hemostatic efficacy of various topical agents, and then to compare fibrin sealant (FS) to an existing stan dard of care for topical hemostasis. A left heminephrectomy was performed i n anesthetized adult male Sprague-Dawley rats. Animals were anticoagulated with 2000 IU/kg heparin TV and various topical hemostatic agents were appli ed to the injury. Treatment groups included FS applied as a spray; FS appli ed through a cannula; gelatin sponge (GS) soaked in 1000 IU/mL thrombin sol ution; GS soaked in 300 IU/mL thrombin; dry GS; and fibrinogen without thro mbin applied as a spray. The main endpoints of the study were incidence of hemostasis, blood loss, acute survival trends, and maintenance of mean arte rial pressure (MAP). Three treatment groups, the two FS groups and the GS s oaked in 1000 IU/mL,thrombin, afforded significant hemostasis compared to t he controls (P < 0.01). Both FS groups had significantly less blood loss, l onger survival times, and maintained higher MAPs than the GS-treated groups . Quantitative dose effects and functional deficiencies in topical hemostat ic products could be assessed using this animal model. The study demonstrat ed that liquid FS was significantly more efficacious than a GS soaked in th rombin for abating hemorrhage from a renal excision in a heparinized rat. ( C) 2000 Academic Press.