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Surgeons Develop Innovative Life-Saving Treatments to Correct Massive Bleeding in Trauma Patients
Date:10/9/2007

ese patients die is massive bleeding. "If you look at autopsy data, most patients have bleeding problems that were fixable. We weren't able to fix them because once patients lose enough blood, they go into cardiac arrest, and the brain dies in about 4-5 minutes. We simply don't have enough time to get to the bleeding source and control it." Dr. Alam said.

Profound cooling of the body decreases the metabolic rate of the brain so it slows down but does not completely stop. So instead of consuming huge amounts of oxygen, the brain can be kept alive with only small amounts of oxygen delivery. According to Dr. Alam, once the brain is cooled down to about 10 degrees C, it can stay alive for about two hours, giving surgeons enough time to fix underlying bleeding problems.

Dr. Alam and his research associates have been testing hypothermia as a treatment for massive blood loss for about five years. In that time, they have determined the optimal rate of cooling and rewarming, the desired depth and duration of cooling, and other practical aspects of the technique through a series of studies.

Their most recent studies have evaluated the effectiveness of hypothermia in an extremely challenging model--a combination of massive blood loss as well as injuries to major organs. "The goal of this study was to take the technique into a realistic scenario. In the past, we found that the technique worked in models that had no confounding variable other than an injury to a blood vessel, which is easy enough to fix. Once you get to it, you sew it up and you control the bleeding. But what if you have an injury to the abdomen and there is spillage of stool in the abdomen or an injury to the liver or the spleen that continues to spill blood? This study looked at a realistic lifelike trauma scenario," Dr. Alam explained. The findings were presented at the ACS Clinical Congress last year. This year, they have made the model even more challenging by inducing profound hypother
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SOURCE American College of Surgeons
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