No abstract

Mild therapeutic hypothermia is considered standard care in the treatment of patients resuscitated from cardiac arrest. With increasingly more frequent concomitant use of platelet-inhibiting drugs, clinicians must be cognizant of the ramifications of hypothermia on platelet function as part of hemostasis. The effects of hypothermia on platelet function have been studied for more than 50 years, but the results are inconsistent and may be related to the circumstances during which hypothermia is achieved. This review summarizes current knowledge of platelet function during hypothermia and the impact on hemostasis.

No abstract

Composite materials made up from a pyridinium polymer matrix and silver bromide nanoparticles embedded therein feature excellent antimicrobial properties. Most probably, the antimicrobial activity is related to the membrane-disrupting effect of both the polymer matrix and Ag(+) ions; both may work synergistically. One of the most important applications of antimicrobial materials would be their use as surface coatings for percutaneous (skin-penetrating) catheters, such as central venous catheters (CVCs). These are commonly used in critical care, and serious complications due to bacterial infection occur frequently. This study aimed at examining the possible effects of a highly antimicrobial pyridinium polymer/AgBr composite on the blood coagulation system, i.e., (i) on the coagulation cascade, leading to the formation of thrombin and a fibrin cross-linked network, and (ii) on blood platelets. Evidently, pyridinium/AgBr composites could not qualify as coatings for CVCs if they trigger blood coagulation. Using a highly antimicrobial composite of poly(4-vinylpyridine)-co-poly(4-vinyl-N-hexylpyridinium bromide) (NPVP) and AgBr nanoparticles as a thin adherent surface coating on Tygon elastomer tubes, it was found that contacting blood platelets rapidly acquire a highly activated state, after which they become substantially disrupted. This implies that NPVP/AgBr is by no means blood-compatible. This disqualifies the material for use as a CVC coating. This information, combined with earlier findings on the hemolytic effects (i.e., disruption of contacting red blood cells) of similar materials, implies that this class of antimicrobial materials affects not only bacteria but also mammalian cells. This would render them more useful outside the biomedical field.