Use of a modified chitosan dressing in a hypothermic Coagulopathic grade V liver injury model

Bochicchio, Grant V.; Kilbourne, Michael; Kuehn, Reed; Keledjian, Kaspar; Hess, John R.; Scalea, Thomas M.

doi:10.1016/j.amjsurg.2009.07.028

Cited by 23 publications

(11 citation statements)

References 27 publications

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“…N , O -carboxymethylchitosan (NOCC) could decrease the whole blood clotting time (WHBCT) and lower the plasma recalcification time (PRT) value, similar to that of chitosan and chitin [95]. When used in a hypothermic coagulopathic grade V liver injury, Bochicchio et al found that a modified chitosan patch (MCP) could significantly reduce the post treatment blood loss and increase resuscitation mean arterial pressure (P < 0.0001 and P < 0.018, respectively) [96]. The photocrosslinkable chitosan (Az-CH-LA) is a chitosan hydrogel containing both lactose moieties and photoreactive azide groups.…”

Section: Hemostasis Effects Of Chitosan and Its Derivativesmentioning

confidence: 99%

Chitosan Modification and Pharmaceutical/Biomedical Applications

et al. 2010

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Chitosan has received much attention as a functional biopolymer for diverse applications, especially in pharmaceutics and medicine. Our recent efforts focused on the chemical and biological modification of chitosan in order to increase its solubility in aqueous solutions and absorbability in the in vivo system, thus for a better use of chitosan. This review summarizes chitosan modification and its pharmaceutical/biomedical applications based on our achievements as well as the domestic and overseas developments: (1) enzymatic preparation of low molecular weight chitosans/chitooligosaccharides with their hypocholesterolemic and immuno-modulating effects; (2) the effects of chitin, chitosan and their derivatives on blood hemostasis; and (3) synthesis of a non-toxic ion ligand—D-Glucosaminic acid from Oxidation of D-Glucosamine for cancer and diabetes therapy.

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Section: Hemostasis Effects Of Chitosan and Its Derivativesmentioning

confidence: 99%

Chitosan Modification and Pharmaceutical/Biomedical Applications

et al. 2010

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“…Beside acidosis and coagulopathy, accidental hypothermia is recognised as one main pillar of the lethal triad after severe trauma [ 19 , 33 ]. Both acidosis and hypothermia are well known to exert significant effects on the coagulation system, resulting in a significantly higher blood loss due to an increased bleeding time [ 34 ] and enhanced mortality rate [ 34 , 35 ]. Acidosis was proposed to be more detrimental than hypothermia in the development of coagulopathy [ 34 ].…”

Section: Reviewmentioning

confidence: 99%

Relevance of induced and accidental hypothermia after trauma-haemorrhage–what do we know from experimental models in pigs?

Hildebrand

Radermacher

Ruchholtz

et al. 2014

ICMx

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Recent experimental research has either focused on the role of accidental hypothermia as part of the lethal triad after trauma or tried to elucidate the effects of therapeutically induced hypothermia on the posttraumatic course. Induced hypothermia seems to reduce the mortality in experimental models of trauma-haemorrhage. As potential mechanisms, a decrease of cellular metabolism, beneficial effects on haemodynamic function and an attenuation of the inflammatory response have been described. However, negative side effects of hypothermia have to be considered, such as impairment of the coagulatory function and immunosuppressive effects. Furthermore, the optimal strategy for the induction of hypothermia (magnitude, duration, timing, cooling rate, etc.) and subsequent rewarming remains unclear. Nevertheless, this piece of information is essential before considering hypothermia as a treatment strategy for severely injured patients. This review aims to elaborate the differences between accidental and induced hypothermia and to summarize the current knowledge of the potential therapeutic use of induced hypothermia suggested in porcine models of trauma-haemorrhage.Electronic supplementary materialThe online version of this article (doi:10.1186/2197-425X-2-16) contains supplementary material, which is available to authorized users.

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“…Omni-stat is currently available in granule form for use in the treatment of irregular wounds and has been studied in porcine models of large groin vessel injury [8,9]. A modified chitosan dressing has been investigated for efficacy in a hypothermic coagulopathic swine model [10]. Chitosan granules were effective in achieving haemostasis in liver lacerations in a heparinized swine model [11].…”

Section: Introductionmentioning

confidence: 99%

In vivo Evaluation of the Chitosan-Based Haemostatic Agent Omni-stat® in Porcine Liver Resection and in Liver Injury

2012

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Background: Omni-stat®, a polysaccharide made by de-acetylation of chitin, is currently in use as a battlefield topical haemostat. This experimental study undertakes the first evaluation of Omni-stat in an in vivo porcine hepatectomy and liver trauma model. Methods: A model of sequential liver resection was employed: following liver resection, further resections were undertaken in the same animal provided that there was cessation of bleeding from the earlier resection and that haemodynamic stability was maintained. An additional liver trauma injury was undertaken after completion of all resections. Data were collected on heart rate, blood pressure, haematocrit, resection volumes, blood loss and the efficacy of Omni-stat in haemostasis. Results: Eight minor resections and 12 major resections were undertaken. Topical application of Omni-stat to raw post-transection surfaces immediately upon completion of resection achieved complete haemostasis with a single application in 14 of 15 (93%) resections. There was no recurrence of bleeding during the 5-hour protocol. The median time for cessation of bleeding after resection in the Omni-stat group was 3 min (range 3–6). This was not significantly different from time to cessation of bleeding in 5 control resections. There was no difference in blood loss or haemodynamic parameters. Respiratory rate was significantly faster after application of Omni-stat. In 2 liver lacerations, Omni-stat was effective in achieving cessation of haemorrhage. Conclusion: Omni-stat is an effective haemostat in experimental in vivo porcine liver resection and liver trauma. Further evaluation is required to assess its physiological absorption profile in man and its comparative efficacy against commercially established agents.

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Use of a modified chitosan dressing in a hypothermic Coagulopathic grade V liver injury model

Cited by 23 publications

References 27 publications

Chitosan Modification and Pharmaceutical/Biomedical Applications

Chitosan Modification and Pharmaceutical/Biomedical Applications

Relevance of induced and accidental hypothermia after trauma-haemorrhage–what do we know from experimental models in pigs?

In vivo Evaluation of the Chitosan-Based Haemostatic Agent Omni-stat® in Porcine Liver Resection and in Liver Injury

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