Hemostatic effect of a chitosan linear polymer (Celox®) in a severe femoral artery bleeding rat model under hypothermia or warfarin therapy

Köksal, Özlem; Özdemir, Fatma Nurhan; Etoz, Betul Cam; Büyükcoşkun, Naciye Işbil; Sığırlı, Deniz

doi:10.5505/tjtes.2011.88155

Cited by 34 publications

(27 citation statements)

References 32 publications

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“…The reduction it causes in haemostasis can be offset by the use of topical haemostatic agents and modern military type tourniquets, which work well despite low patient core body temperature 6. The use of these methods coupled with future advances in emergency preservation and resuscitation look set to revolutionise treatment of hypovolaemic trauma victims.…”

Section: Discussionmentioning

confidence: 99%

“…An interesting result in the two control groups of the study into hypothermia and the effectiveness of chitosan based haemostatic agent showed a survival rate of 75% among haemorrhaging hypothermic models when compression was used (without haemostatic agent) to arrest bleeding. In comparison, normothermic haemorrhaging models showed a 50% survival rate when compression was used (without haemostatic agent) to arrest bleeding 6. In both the hypothermic and normothermic groups using the haemostatic agent to arrest bleeding, a 100% survival rate was achieved 6.…”

Section: Clinically Induced Hypothermiamentioning

confidence: 96%

“…The use of chitosan based topical haemostatic agents has been shown to effectively control haemorrhaging in hypothermic conditions 6. An interesting result in the two control groups of the study into hypothermia and the effectiveness of chitosan based haemostatic agent showed a survival rate of 75% among haemorrhaging hypothermic models when compression was used (without haemostatic agent) to arrest bleeding.…”

Section: Clinically Induced Hypothermiamentioning

confidence: 97%

“…In comparison, normothermic haemorrhaging models showed a 50% survival rate when compression was used (without haemostatic agent) to arrest bleeding 6. In both the hypothermic and normothermic groups using the haemostatic agent to arrest bleeding, a 100% survival rate was achieved 6. The difference in the survival rates using compression alone may indicate the potential benefits of induced hypothermia in a test that allows free bleeding instead of blood withdrawal.…”

Section: Clinically Induced Hypothermiamentioning

confidence: 98%

“…Some of these advances have been in the assessment, management and treatment of the severely injured patient. Damage control protocol, advances in topical haemostatic agents and other methods can provide good survival rates in severely wounded patients5 or test subjects 6…”

Section: Introductionmentioning

confidence: 99%

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Hypothermia in trauma

Moffatt

2012

Emerg Med J

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Hypovolaemic shock that results through traumatically inflicted haemorrhage can have disastrous consequences for the victim. Initially the body can compensate for lost circulating volume, but as haemorrhage continues compensatory mechanisms fail and the patient's condition worsens significantly. Hypovolaemia results in the lethal triad, a combination of hypothermia, acidosis and coagulopathy, three factors that are interlinked and serve to worsen each other. The lethal triad is a form of vicious cycle, which unless broken will result in death. This report will focus on the role of hypothermia (a third of the lethal triad) in trauma, examining literature to assess how prehospital temperature control can impact on the trauma patient. Spontaneous hypothermia following trauma has severely deleterious consequences for the trauma victim; however, both active warming of patients and clinically induced hypothermia can produce particularly positive results and improve patient outcome. Possible coagulopathic side effects of clinically induced hypothermia may be corrected with topical haemostatic agents, with the benefits of an extended golden hour given by clinically induced hypothermia far outweighing these risks. Active warming of patients, to prevent spontaneous trauma induced hypothermia, is currently the only viable method currently available to improve patient outcome. This method is easy to implement requiring simple protocols and contributes significantly to interrupting the lethal triad. However, the future of trauma care appears to lie with clinically induced therapeutic hypothermia. This new treatment provides optimism that in the future the number of deaths resulting from catastrophic haemorrhaging may be significantly lessened.

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Section: Discussionmentioning

confidence: 99%

Section: Clinically Induced Hypothermiamentioning

confidence: 96%

Section: Clinically Induced Hypothermiamentioning

confidence: 97%

Section: Clinically Induced Hypothermiamentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Hypothermia in trauma

Moffatt

2012

Emerg Med J

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Hemostatic strategies for uncontrolled bleeding: A comprehensive update

et al. 2021

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Uncontrolled bleeding remains the leading cause of morbidity and mortality across the entire macrocosm. It refers to excessive loss of blood that occurs inside of body, due to unsuccessful platelet plug formation at the injury site. It is not only limited to the battlefield, but remains the second leading cause of death amongst the civilians, as a result of traumatic injury. Startlingly, there are no effective treatments currently available, to cater the issue of internal bleeding, even though early intervention is of utmost significance in minimizing the mortality rates associated with it. The fatal issue of uncontrolled bleeding is ineffectively being dealt with the use of pressure dressings, tourniquet, and surgical procedures. This is not a practical approach in combat arenas or in emergency situations, where the traumatic injury inflicted is deep inside the body, and cannot be addressed externally, by the application of topical dressings. This review focuses on the traditional hemostatic agents that are used to augment the process of hemostasis, such as mineral zeolites, chitosan based products, biologically active agents, anti‐fibrinolytics, absorbable agents, and albumin and glutaraldehyde, as well as the micro‐ and nano‐based hemostatic agents such as synthocytes, thromboerythrocytes, thrombosomes, and the synthetic platelets.

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Genipin crosslinked microspheres as an effective hemostatic agent

Xiao

et al. 2018

Polymers for Advanced Techs

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Efficient hemorrhage control is of extreme importance to decrease mortality rates arising from traumatic bleeding. However, traditional hemostatic agents are limited to unsatisfied biocompatibility, inconvenient usage, and high cost. To this end, we have devised a novel hemostatic microsphere from chitosan and gelatin by using appropriate amount of genipin as a crosslinker. The performance of these Cs/GelMPs was evaluated with experiments in vitro and in vivo. Results in vitro showed that the best hemostatic efficacy was achieved by Cs/Gel-0.75 MPs (the mass fraction of genipin in Cs/Gel mixture is 8.6 × 10 −6 ). Skin laceration model indicated that the hemostatic time of Cs/Gel-0.75 MPs was within 12 seconds, which has been significantly shortened in comparison with commercial available products. Moreover, cytocompatibility results displayed that Cs/Gel-0.75 MPs caused no obvious cytotoxicity even at the high concentration of 40 μg/ml. Cs/Gel-0.75 MPs also possess satisfactory fluid absorption ratio and low hemolysis. Therefore, these Cs/Gel-0.75 MPs are promising candidates for further surgical wound hemostatic agent.

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Hemostatic effect of a chitosan linear polymer (Celox®) in a severe femoral artery bleeding rat model under hypothermia or warfarin therapy

Cited by 34 publications

References 32 publications

Hypothermia in trauma

Hypothermia in trauma

Hemostatic strategies for uncontrolled bleeding: A comprehensive update

Genipin crosslinked microspheres as an effective hemostatic agent

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