Evaluation of the safety and efficacy of a new hemostatic powder using a quantitative surface bleeding severity scale

J Card Surg. 2019 Jan;34(1):50-62. doi: 10.1111/jocs.13982. Epub 2019 Jan 10.

Abstract

Aims of the study: The safety and efficacy of a hemostatic powder (HP) versus a control agent, absorbable gelatin sponge and thrombin (G + T), were assessed, using a validated, quantitative bleeding severity scale.

Methods: Subjects were randomized to receive HP (256 subjects) or G + T (132 subjects) for treatment of minimal, mild, or moderate bleeding at 20 investigational sites. The primary efficacy endpoint was non-inferiority of HP relative to G + T for success at achieving hemostasis within 6 minutes. Secondary endpoints in rank order included: superiority of HP relative to G + T in mean preparation time; non-inferiority of HP relative to G + T for achieving hemostasis within 3 min; superiority of HP relative to G + T for achieving hemostasis within 6 min; and superiority of HP relative to G + T for success for achieving hemostasis within 3 min.

Results: A total of 388 subjects were included in the primary efficacy analysis. At 6 min, hemostasis was achieved in 93.0% (238/256) of the HP group compared to 77.3% (102/132) of the G + T group (non-inferiority P < 0.0001, superiority P < 0.0001). All secondary endpoints were met. Complications were comparable between treatment groups.

Conclusions: HP had superior rates of hemostasis, shorter preparation time, and a similar safety profile compared to G + T in this prospective, randomized trial using quantitative bleeding severity criteria.

Keywords: bleeding scale; collagen; hemostat; hemostatic agent; hemostatic powder; thrombin.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical / prevention & control*
  • Female
  • Follow-Up Studies
  • Gelatin Sponge, Absorbable / pharmacology*
  • Hemostatics / pharmacology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / drug therapy*
  • Prospective Studies
  • Thrombin / pharmacology*
  • Treatment Outcome

Substances

  • Hemostatics
  • Thrombin

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