Efficacy and safety of CounterFlow in animal models of hemorrhage.

INTRODUCTION

Hemorrhage is a major cause of battlefield mortality, contributing to 91% of potentially survivable combat-related deaths. Death from hemorrhage often occurs in pre-hospital settings, and more efficacious hemorrhage control interventions are needed to extend survival and enable casualties to reach definitive surgery. CounterFlow is a novel topical hemostatic agent that uses self-propelling particles to deliver thrombin and tranexamic acid against active bleeding. It achieves and maintains hemostasis at the site of injury through a combination of mechanical, biological, and chemical effects.

METHODS

All literature in which CounterFlow was tested in animal models of hemorrhage was reviewed to compile its preclinical safety and efficacy as a hemostatic agent.

RESULTS

CounterFlow extended survival and halted hemorrhage in multiple animal models that mimicked common and deadly injuries encountered in military and civilian settings, including junctional wounds, surgical bleeding, non-compressible intra-abdominal hemorrhage, and upper gastrointestinal bleeding. Thromboembolism, tissue damage, and toxicity were not observed.

DISCUSSION: This narrative review discusses the animal models that have been used to investigate CounterFlow as a hemostatic agent for pre-hospital hemorrhage control. Future directions and potential expansion for civilian use are also considered.