Advances in Topical Hemostatic Agent Therapies: A Comprehensive Update
- PDF / 1,014,227 Bytes
- 17 Pages / 595.276 x 790.866 pts Page_size
- 83 Downloads / 167 Views
REVIEW
Advances in Topical Hemostatic Agent Therapies: A Comprehensive Update Liang Huang . Geoffrey L. Liu . Alan D. Kaye . Henry Liu
Received: July 9, 2020 Ó The Author(s) 2020
ABSTRACT Severe hemorrhage causes significant metabolic and cellular dysfunction secondary to deficient tissue perfusion and oxygen delivery. If bleeding continues, hemodynamic destabilization, hypoxemia, multiple organ failure, and death will occur. Techniques employed to promote hemostasis include surgical suture ligatures, cautery, chemical agents, self-assembling nanoparticles, and physical methods, like
mechanical pressure. Improved understanding of the natural clotting cascade has allowed newly designed agents to become more targeted for clinical and military use. Topically-applied hemostatic agents have enormous clinical applications in achieving hemostasis. This manuscript describes currently available and developing topical hemostatic materials, including topical active agents, mechanical agents, synthetic/hemisynthetic hemostatic agents, and external hemostatic dressings for clinical practice.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12767606. L. Huang Department of Anesthesiology, Perioperative and Pain Medicine, New York University Langone School of Medicine, New York, USA G. L. Liu Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA, USA A. D. Kaye Department of Anesthesiology and Pharmacology, LSU Health Shreveport, Shreveport, LA, USA A. D. Kaye Department of Toxicology, and Neurosciences, LSU Health Shreveport, Shreveport, LA, USA H. Liu (&) Department of Anesthesiology and Perioperative Medicine, Milton S. Hershey Medical Center, Penn State University School of Medicine, Hershey, PA, USA e-mail: [email protected]
Keywords: Adhesive; Fibrin; Hemostatic dressings; Hemostats; Thrombin; Topical agent
Gelatin; Sealant;
Key Summary Points Severe hemorrhage causes significant hemodynamic instability, hypoxemia, multiple organ failure, and death. Perioperative hemostasis techniques include surgical ligatures, cautery, chemical agents, self-assembling nanoparticles, and topical methods. Topically-applied hemostatic agents include active agents, mechanical agents, synthetic agents, and external dressings.
Adv Ther
Topical mechanical agents only work in patients with intact coagulation system. Appropriate method is determined by the type of bleeding, the specific etiology, the individual coagulation status, and the clinician’s experience and preference. Future hemostatic agents can be engineered towards both primary and secondary hemostasis mechanisms for an enhanced hemostatic response.
INTRODUCTION Various factors, such as surgery and trauma, can cause hemorrhage in human beings. Severe hemorrhage can potentially induce significant morbidity and mortality. Hemorrhage ensues if the vascular wall integrity gets disrupted [1]. The extent of cellular injury and organ dysfunction secondary to hemorrhage is a complex process dependent upon the dura
Data Loading...
