Efficacy of Hemostatic Agents in Humans With Rotational Thromboelastometry: An<i>in-vitro</i>Study

Lechner, Raimund; Helm, Matthias; Mueller, Maximilian; Wille, Timo; Friemert, Benedikt

doi:10.7205/milmed-d-15-00417

Cited by 15 publications

(17 citation statements)

References 33 publications

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“…With the QC hemostatic device, the time of thrombus formation, thrombus stability, and resistance for lysis were greater than those in thrombus created by standard processes of hemostasis using SC. These data were presented in a small study by Lechner et al The aim of this trial was to assess the efficacy of hemostatic dressings in human blood [25]. Protocols of using QC in real life have differences depending on local experiences.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

et al. 2019

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Hemostatic devices used in the transradial approach (TRA) and transulnar approach (TUA) are limited. This study compared the efficacy and safety of hemostasis using the QuikClot Radial hemostatic pad (QC) vs. standard mechanical compression (SC) after coronary angiography (CAG). This prospective single-center randomized trial included CAG patients. The primary and secondary endpoints were efficacy (successful hemostasis) and safety (total artery occlusion [TAO], pseudoaneurysm, hematoma), respectively. A visual analog scale (VAS) evaluated patient pain during compression. In 2013-2017, 200 patients were randomized 2 × 2 into the: (1) TRA and TUA groups and (2) QC and SC groups. Successful hemostasis was achieved in 92 (92%) patients in the QC group and 100 (100%) patients in the SC group (p < 0.006). The TRA SC subgroup showed significantly better results than the TRA QC subgroup (100% vs. 90.0%; p < 0.03). Similar results were obtained in the TUA QC and TUA SC subgroups (95% vs. 100%; p = 0.5). The secondary endpoint was achieved in the QC and SC groups (8% vs. 9%; p = 0.8). Patients reported significantly less pain during QC application than during SC (VAS: 2.6 ± 2.6 vs. 3.4 ± 2.9; p < 0.03). In patients undergoing CAG with TRA or TUA, QC was associated with lower efficacy, less discomfort, and similar safety compared to SC.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

et al. 2019

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“…Chitosan is also well known for its antimicrobial properties, and its protection against a wide range of bacteria enhances its appeal as a bandage, where it has found use as the active component in a number of commercial wound dressings, including HemCon®, Chitodine®, TraumaDEX®, Celox™, and others 4–6 . The efficacy of chitosan-based hemostatic agents has been established in significantly improving survival rates and the reduction of blood loss, by accelerating and strengthening blood clots 7,8 . As these technologies rely on a high surface area to promote interaction with platelets and coagulation factors, maximizing the surface area of these chitosan-based materials is a critical initiative for improving their effectiveness 9 .…”

Section: Introductionmentioning

confidence: 99%

Absorbable hemostatic hydrogels comprising composites of sacrificial templates and honeycomb-like nanofibrous mats of chitosan

et al. 2019

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The development of hemostatic technologies that suit a diverse range of emergency scenarios is a critical initiative, and there is an increasing interest in the development of absorbable dressings that can be left in the injury site and degrade to reduce the duration of interventional procedures. In the current study, β-cyclodextrin polyester (CDPE) hydrogels serve as sacrificial macroporous carriers, capable of degradation under physiological conditions. The CDPE template enables the assembly of imprinted chitosan honeycomb-like monolithic mats, containing highly entangled nanofibers with diameters of 9.2 ± 3.7 nm, thereby achieving an increase in the surface area of chitosan to improve hemostatic efficiency. In vivo, chitosan-loaded cyclodextrin (CDPE-Cs) hydrogels yield significantly lower amounts of blood loss and shorter times to hemostasis compared with commercially available absorbable hemostatic dressings, and are highly biocompatible. The designed hydrogels demonstrate promising hemostatic efficiency, as a physiologically-benign approach to mitigating blood loss in tissue-injury scenarios.

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“…BZG is a zeolite-based bio-inorganic hybrid hemostatic gauze with a surface Ca ion exchange rate of 87%, which can promote the conversion of prothrombin from normal plasma and factor X de cient plasma to thrombin [16,17]. In contrast, kaolin is the main hemostatic component of QCG and exerts its hemostatic effect through activating the endogenous coagulation pathway [12,21]. When TIC occurs, the level of coagulation factor XII and the activation e ciency of the endogenous activation pathway decrease, resulting in a decrease in the hemostatic effect of QCG; while the decreased level of coagulation factor X will further decrease the hemostatic effect of QCG.…”

Section: Discussionmentioning

confidence: 99%

Comparative observations of the hemostatic effects of bio-zeolite gauze and QuickClot Combat Gauze on massive hemorrhage with coagulopathy

Yang

Jia

Xiao³

et al. 2023

Preprint

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BACKGROUND The presence of coagulopathy after bleeding negatively affects the hemostatic effects of gauze. In this study, we compared the hemostatic effects of bio-zeolite gauze (BZG) and QuickClot Combat Gauze (QCG) on massive hemorrhage complicated by coagulopathy. Methods In 30 rabbits, diluted coagulopathy was prepared by extraction of blood at a dose of 15 mL/kg body weight following infusion with saline three times the volume of blood loss. Then, simulated blast-induced pelvic injury was initiated to produce massive hemorrhage using a custom-made machine, as previously reported. The rabbits were then randomly allocated to three groups, namely A, B, and C, in which BZG, QCG, and ordinary gauze were used to prevent bleeding, respectively. The primary outcomes, including the immediate hemostasis rate, blood loss, and survival rate, were recorded at designated time points. Additionally, blood samples were taken for laboratory examinations, including conventional coagulation, thromboelastography, full blood count, blood biochemistry, and enzyme-linked immunosorbent assay. Results Animal models of diluted coagulopathy and major bleeding were successfully developed with decreased concentrations of coagulation factors XII and X. The overall effects of BZG were better than those of QCG and ordinary gauze, with a higher immediate hemostatic rate, less blood loss at 10 min and 30 min after gauze application, and higher red blood cell and platelet counts, higher maximum amplitude, lower R values, lower levels of creatinine, and lower levels of alanine aminotransferase at 30 min after gauze application. Furthermore, a higher survival rate was found in group A rabbits than in group B and group C rabbits at 90 min after gauze application. Conclusions BZG demonstrated better hemostatic performance than QCG and normal gauze for massive hemorrhage complicated by coagulopathy. BZG is a suitable hemostatic gauze for control of massive hemorrhage complicated by coagulopathy.

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Efficacy of Hemostatic Agents in Humans With Rotational Thromboelastometry: Anin-vitroStudy

Cited by 15 publications

References 33 publications

Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

Absorbable hemostatic hydrogels comprising composites of sacrificial templates and honeycomb-like nanofibrous mats of chitosan

Comparative observations of the hemostatic effects of bio-zeolite gauze and QuickClot Combat Gauze on massive hemorrhage with coagulopathy

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