Abstract
Trauma is a leading cause of death among young individuals globally and uncontrolled hemorrhage is the leading cause of preventable death. Controlling hemorrhage from a solid organ is often very challenging in military as well as civilian setting. Recent studies demonstrated reversible vasoconstriction and irreversible thrombosis following application of microseconds-long electrical pulses. The current paper describes for the first time reduction in bleeding from the injured liver in rat and rabbit model in-vivo. We applied short (25 and 50 µs) electrical pulses of 1250 V/cm to rats and rabbit liver following induction of standardized penetrating injury and measured the amount of bleeding into the abdominal cavity one hour post injury. We found a 60 and 36 percent reduction in blood volume in rats treated by 25 µs and 50 µs, respectively (P<0.001). Similar results were found for the rabbit model. Finite element simulation revealed that the effect was likely non-thermal. Histological evaluation found local cellular injury with intravascular thrombosis. Further research should be done to fully explore the mechanism of action and the potential use of short electric pulses for hemorrhage control.
Highlights
Trauma is a leading cause of death among young individuals globally
Our results demonstrate that short electrical pulses decreased the bleeding volume from liver injury by 60 and 44 percent for rats and rabbits, respectively (Fig. 1, Table 1)
The bleeding volume was not different between the NT group and the MP group in rats, suggesting that the treatment effect was not caused by the mechanical pressure applied by the electrodes per-se, but rather by the electric field applied on the tissue
Summary
Trauma is a leading cause of death among young individuals globally. Uncontrolled non-compressible hemorrhage is the leading cause of preventable deaths [1,2,3,4]. High Intensity Focused Ultrasound (HIFU) [7,8] induces a rapid tissue temperature increase and cavitation formation, both leading to thrombosis and platelets activation [9] This technique causes adverse reactions such as irreversible destruction of the liver and the blood vessels. Another potential treatment for liver injury is the intra-operative application of homeostatic bandages which were demonstrated to be effective in controlling liver hemorrhage in large animal models [10]. These techniques, as well as others [11,12], are still under evaluation and have not yet been proven to offer a satisfactory solution to the clinical needs, especially as they all require surgical exposure of the bleeding site
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