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Table 1 Potential hemostatic agents for prehospital and combat hemorrhage control

From: Hemostatic agents for prehospital hemorrhage control: a narrative review

Typical hemostatsBleeding sitesComments
Intravenous infusion
 Coagulation factor concentrates: fibrinogen, recombinant factor VII, prothrombin complex [33,34,35,36]Extremity/junctional/truncal hemorrhageUsed clinically and in remote operational environments, showing logistic benefits, requiring more randomized controlled trials for clinical benefits
 Dried plasma [37, 38]Extremity/junctional/truncal hemorrhageUsed prehospitally and on the battlefield, showing logistic benefits and a positive effect on coagulation profile, with no effects on other outcomes
 Tranexamic acid [39,40,41,42]Extremity/junctional/truncal hemorrhageUsed prehospitally and on the battlefield, suggesting a survival advantage to severely bleeding patients
 Dried platelets [43,44,45]Extremity/junctional/truncal hemorrhageUnder development
 Platelet substitutes/synthetic platelets [46,47,48]Extremity/junctional/truncal hemorrhageUnder development
 Synthetic polymers: polySTAT [49,50,51]Extremity/junctional/truncal hemorrhageUnder development, improved survival compared to an albumin control in a rat femoral artery injury
Local application
 Hemostatic dressings: Combat Gauze, Celox Gauze, ChitoGauze, HemCon dressing [52,53,54]Extremity/junctional hemorrhageUsed on the battlefield and in prehospital settings
 Injectable and self-expanding sponges (XStat), intracavitary forms (ResQFoam, ClotFoam), in situ forming gels, self-propelling particles [19, 25, 27, 55, 56]Truncal hemorrhageUnder development