Journal articles on the topic 'Hemostasis'
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1
Rathod, Dr Rohit Narendra. "Hemostasis in the Surgical Field." EAS Journal of Medicine and Surgery 4, no. 10 (November 16, 2022): 211–14. http://dx.doi.org/10.36349/easjms.2022.v04i10.003.
Abstract:
Hemostatic mechanisms are an integral a part of the human physiology. Traditionally divided into intrinsic and extrinsic arms, the coagulation cascade converges, through the interactions of the many various factors, at a standard element—thrombin. As a consequence, variety of various agents is developed to supplement this common, critical step to assist surgical hemostasis. Intraoperative interventions most ordinarily include sutures and heat-generating cautery devices; however, these methods are sometimes insufficient or inappropriate for a selected procedure or anatomic location, resulting in the event of other adjunctive therapies, including topical hemostats. Topical hemostatic agents generally act as active, passive, and combinations therapies, counting on their individual composition and mode of action. We offer a quick review of the traditional coagulation cascade, including critical points, followed by a discussion of surgical strategies and adjuctive therapies want to achieve surgical hemostasis and concluding with a discussion of topical thrombins.
2
Romantsov, Mikhail N., Eugene F. Cherednikov, Aleksandr Anatolevich Glukhov, and Constantine O. Fursov. "New technologies of endoscopic hemostasis in a treatment protocol of patients with gastroduodenal ulcer bleeding." Vestnik of Experimental and Clinical Surgery 11, no. 1 (April 8, 2018): 16–23. http://dx.doi.org/10.18499/2070-478x-2018-11-1-16-23.
Abstract:
Relevance of research. Acute gastroduodenal bleeding is remaining a difficult and largely unsolved problem up to day. The fundamental importance in treating this category of patients is an endoscopic hemostasis. The decisive point in this problem is the most stable hemostasis and preventing a recurrence of a hemorrhage. In this regard, the search of new solutions and the development of known methods of treatment of the gastroduodenal ulcer bleeding is an important issue.
Aim of research. To evaluate the effectiveness of the treatment protocol of patients with the gastroduodenal ulcer bleeding by applying combined endoscopic insufflations of hemostatic agents and a diovin as an integral part of a complex therapy.
Materials and methods. The research is based on results of treatment of the patients with the gastroduodenal ulcer bleeding being in a medical setting at the departments of surgery at Voronezh city clinical emergency hospital №1. During the treatment of the main group (59 patients) there was used an integrated approach with the usage of powdered hemostatic agents of gelplastan and lyophilisate NovoSeven in combination with diovin in the endoscopic treatment of gastroduodenal ulcer bleeding. There were used the traditional well-known methods of the endoscopic hemostasis without the usage of hemostatic agents and absorbent grains in treatment of the control group (56 patients).
Results and discussion. The evaluation of results of patients’ treatment with gastroduodenal ulcer bleeding was performed according to the figures of the final hemostasis, the frequency of recurrent bleeding, the prevention of emergency operations, the rates of mortality, the duration of hospitalization. The developed protocol of the patients’ treatment with gastroduodenal ulcer bleeding with the usage of combined the endoscopic insufflation of two hemostatics and diovin makes it possible to achieve the maximum persistent hemostasis at 94.9% of patients, to reduce the risk of recurrent hemorrhages by 2.5 times, to prevent emergency operations and, as a result, to reduce the lethality.
Conclusion. The usage of new technologies of endoscopic hemostasis by the hemostatic pneumoinsufflation gelplastan and lyophilisate NovoSeven in combination with diovin in the treatment of patients with gastroduodenal ulcer bleeding allows to reduce the risk of recurrent hemorrhage from 12,5% to 5,01% (by 2,5 times), to prevent emergency operations, to reduce the lethality from 3,65% to 1,7% (by 2,1 times) and to reduce the period of staying in the hospital from 10,2 to 7,4 bed days (p<0.05).
3
Budko, E. V., L. M. Yampolsky, D. A. Chernikova, and A. A. Khabarov. "Comparative evaluation of the effectiveness of a local hemostatic agent modified with a bio-organic composition." CARDIOMETRY, no. 18 (May 18, 2021): 100–112. http://dx.doi.org/10.18137/cardiometry.2021.18.100112.
Abstract:
Constant attention to the study of the experience of using hemostatic products proposed for local bleeding arrest encourages new developments in this field. Modern hemostatics are porous multilayer systems with an inclusion of active coagulants. The results of the assessment of hemostatic activity obtained with the help of clinical and laboratory methods often do not lend themselves to cross-checking and statistical processing, and do not allow us to study objects with different physical and chemical properties. Methods of chemometrics, namely planimetry, allow you to visualize the parameters of sorption and hemocoagulation activity. A comparative planimetric study of commercial local hemostatic agents like Celox powder, sponges and napkins of various companies, zeolite powder, as well as new hemostatic compositions, which were given provisionally label A52 and A58, was carried out. It is shown that the hemostatic composition labeled as A52 leads to the activation of absorbent materials, the formation of a stable volumetric primary and secondary thrombus. A comparative evaluation of the effectiveness of a new hemostatic agent in an acute experiment shows a high expression of hemostasis (the time of primary hemostasis is 15-20 seconds) and no recurrence of bleeding for the studied samples compared to the reference.
4
Wu, Baofeng, Ruixin Zhang, Chendi Liang, Chengjie Zhang, and Gang Qin. "Study on the Safety of the New Radial Artery Hemostasis Device." Journal of Interventional Cardiology 2022 (April 5, 2022): 1–8. http://dx.doi.org/10.1155/2022/2345584.
Abstract:
Objective. At present, the use of particular radial hemostatic devices after coronary angiography (CAG) or percutaneous coronary intervention (PCI) has become the primary method of hemostasis. Most control studies are based on the products already on the market, while only a few studies are on the new hemostatic devices. The aim of this study is to compare a new radial artery hemostasis device which is transformed based on the invention patent (Application number: CN201510275446) with TR Band (Terumo Medical) to evaluate its clinical effects. Methods. In a prospective randomized clinical trial, 60 patients after CAG or PCI were randomly divided into two groups, patients in the trial group (CD group) using a new radial artery hemostasis device to stop bleeding and the control group (TR group) using the TR Band. The method is to collect relevant data of the two groups and compare the differences in hemostasis, local complications, and patient discomfort between the two groups. Results. The hemostatic devices in both groups achieved adequate hemostasis, and there was no failure to stop bleeding. The new radial artery hemostasis device was better than the TR band in pain and swelling ( P < 0.05 ). There were no significant differences in bleeding, hematoma, ecchymosis, skin damage, and local infection between the two groups ( P > 0.05 ). Conclusions. The sample of the new radial artery hemostasis device can stop bleeding effectively at the puncture site after CAG or PCI and is not inferior to the TR Band balloon hemostatic device in safety and is better in comfort.
5
Han, Wenli, and Shige Wang. "Advances in Hemostatic Hydrogels That Can Adhere to Wet Surfaces." Gels 9, no. 1 (December 22, 2022): 2. http://dx.doi.org/10.3390/gels9010002.
Abstract:
Currently, uncontrolled bleeding remains a serious problem in emergency, surgical and battlefield environments. Despite the specific properties of available hemostatic agents, sealants, and adhesives, effective hemostasis under wet and dynamic conditions remains a challenge. In recent years, polymeric hydrogels with excellent hemostatic properties have received much attention because of their adjustable mechanical properties, high porosity, and biocompatibility. In this review, to investigate the role of hydrogels in hemostasis, the mechanisms of hydrogel hemostasis and adhesion are firstly elucidated, the adhesion design strategies of hemostatic hydrogels in wet environments are briefly introduced, and then, based on a comprehensive literature review, the studies and in vivo applications of wet-adhesive hemostatic hydrogels in different environments are summarized, and the improvement directions of such hydrogels in future studies are proposed.
6
Zhuk, S., and V. Vorobey-Vykhivska. "Dynamics of indicators of hemostatic system as prognostic criteria consequences of ART programs." HEALTH OF WOMAN, no. 5(111) (June 20, 2016): 165–70. http://dx.doi.org/10.15574/hw.2016.111.165.
Abstract:
The article deals with the insurense of haemostatic system on the ART result. The objective: of the study was to establish the relationships between the state of hemostasis in dynamics during the ART program and its results. Patients and methods. The study involved 130 women who underwent infertility treatment through IVF. The dynamics of hemostasis indicators for ART programs is investigated. Results. The trend to a hypercoagulable state in women with failed attempts of IVF is fined. Risk factors ART failure due to hemostasis disorders is established. Conclusions. The evolution of the hemostatic system is an important prognostic criteria on the outcome of ART programs. The lack of signs of a hypercoagulable state can be considered a prerequisite for pregnancy. Dynamic monitoring of hemostasis within ART programs will take timely measures on correction of the hemostatic system and to some extent influence the effects of treatment. Key words: infertility, hemostasis, assisted reproductive technology.
7
Ravn, Hanne. "Hemostasis in Pediatric Cardiac Surgery." Seminars in Thrombosis and Hemostasis 43, no. 07 (June 8, 2017): 682–90. http://dx.doi.org/10.1055/s-0037-1603365.
Abstract:
AbstractThe majority of children undergoing pediatric cardiac surgery with cardiopulmonary bypass require transfusion of blood products. The management of hemostasis in the pediatric population is challenging, partly due to pronounced alterations in several hemostatic parameters following cardiopulmonary bypass. Despite these marked changes being seen quite often, they are not necessarily an indication for hemostatic interventions. This review summarizes and discusses the available monitoring tests of hemostatic impairment during and following pediatric cardiac surgery. It covers standard laboratory tests, viscoelastic test, evaluation of platelet function, fibrinolysis, and the management of anticoagulation including its reversal. Interpretation of hemostatic measurements is done with due respect to the concept of developmental hemostasis, but also cyanotic heart disease, which are considered by some to be associated with an increased risk of bleeding.
8
Jin, Huiyang, and Zhengke Wang. "Advances in Alkylated Chitosan and Its Applications for Hemostasis." Macromol 2, no. 3 (July 27, 2022): 346–60. http://dx.doi.org/10.3390/macromol2030022.
Abstract:
Chitosan, a natural polysaccharide, has been widely used as a biomaterial, especially for hemostasis. However, hemostatic materials processed from pure chitosan have limited hemostatic effect and are extremely unstable in some cases; chemical modification is therefore needed to improve the hemostatic properties of chitosan. Through chemical reactions with hydroxyl and amino groups in chitosan macromolecules, such as alkylation, carboxylation, quaternization, etc., different groups can be introduced into the repeating units. Moreover, the introduction of different substituents can endow chitosan with more functions. For example, the introduction of long alkyl chains can improve its hydrophobic property, and greatly improve its hemostatic property. However, there is still no review of alkylated chitosan for hemostasis. Therefore, we introduce in detail several methods (direct alkylation, reductive alkylation and acylation reaction) for preparing alkylated chitosan and its applications for hemostasis.
9
Park, Jin-Seok, Byung Wook Bang, Su Jin Hong, Eunhye Lee, Kye Sook Kwon, Hyung Kil Kim, Yong Woon Shin, and Don Haeng Lee. "Efficacy of a novel hemostatic adhesive powder in patients with refractory upper gastrointestinal bleeding: a pilot study." Endoscopy 51, no. 05 (January 10, 2019): 458–62. http://dx.doi.org/10.1055/a-0809-5276.
Abstract:
Abstract Background A new hemostatic adhesive powder (UI-EWD) has been developed to reduce the high re-bleeding rates associated with the currently available hemostatic powders. The current study aimed to assess the efficacy of UI-EWD as a salvage therapy for the treatment of refractory upper gastrointestinal bleeding (UGIB). Methods A total of 17 consecutive patients who had failed to achieve hemostasis with conventional endoscopic procedures and had undergone treatment with UI-EWD for endoscopic hemostasis in refractory UGIB were prospectively enrolled in the study. We evaluated the success rate of initial hemostasis and rate of re-bleeding within 30 days. Results All patients underwent successful UI-EWD application at the bleeding site. Initial hemostasis occurred in 16/17 patients (94 %). Re-bleeding within 30 days occurred in 3/16 patients (19 %) who had achieved initial hemostasis. In the second-look endoscopy after 24 hours, hydrogel from UI-EWD was found attached at the bleeding site in 11/16 patients (69 %). Conclusion UI-EWD has a high success rate for initial hemostasis in refractory UGIB and shows promising results in the prevention of re-bleeding.
10
Dambayev, G. Ts, A. N. Baikov, Ye V. Semichev, M. N. Shpisman, A. N. Aleinik, O. I. Deneko, and P. S. Bushlanov. "The intraoperative methods of hemostasis during liver surgeries." Bulletin of Siberian Medicine 10, no. 4 (August 28, 2011): 89–92. http://dx.doi.org/10.20538/1682-0363-2011-4-89-92.
Abstract:
This article deals with a short analysis of intraoperative hemostasis in parenchymatous organs by the example of liver. A brief historical survey is given. The hemostatic sutures developed by different formers and the defects of hemostatic sutures are considered. There are some features of instrumental hemostasis, its advantages and disadvantages. The description of the new developed devices on basis of cold plasma, the hemostatic and antiseptic properties of the devices are presented.
11
Kamamoto, Dai, Tokunori Kanazawa, Eriko Ishihara, Kaoru Yanagisawa, Hideyuki Tomita, Ryo Ueda, Masahiro Jinzaki, Kazunari Yoshida, and Masahiro Toda. "Efficacy of a topical gelatin-thrombin hemostatic matrix, FLOSEAL®, in intracranial tumor resection." Surgical Neurology International 11 (February 7, 2020): 16. http://dx.doi.org/10.25259/sni_272_2019.
Abstract:
Background: Hemostasis plays an important role in safe brain tumor resection and also reduces the risk for surgical complications. This study aimed to evaluate the efficacy of FLOSEAL®, a topical hemostatic agent that contains thrombin and gelatin granules, in brain tumor resections. Methods: We evaluated the hemostatic effect of FLOSEAL by scoring the intensity of bleeding from 1 (mild) to 4 (life threatening). We assessed the rate of success of hemostasis with 100 patients who underwent intracranial tumor resection. We also investigated the duration of the operation, the amount of intra- and postoperative bleeding, the number of hospital stays, and adverse events in patients who used FLOSEAL compared with those who did not use FLOSEAL. Results: FLOSEAL was applied to a total of 109 bleeding areas in 100 patients. A total of 95 bleeding areas had a score of 1 and 91 (96%) showed successful hemostasis. Thirteen bleeding areas scored 2 and 8 (62%) showed hemostasis with the first application of FLOSEAL. The second application was attempted with five bleeding areas and four showed hemostasis. About 94% (103/109 areas) of bleeding points successfully achieved hemostasis by FLOSEAL. Moreover, FLOSEAL significantly decreased the amount of intraoperative bleeding and postoperative bleeding as assessed with computed tomography on 1 day postoperatively compared with no use of FLOSEAL. There were no adverse events related to FLOSEAL use. Conclusion: Our results indicate that FLOSEAL is a reliable, convenient, and safe topical hemostatic agent for intracranial tumor resection.
12
Uba, Yuki, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Akira Miyano, Yoshitaro Yamamoto, et al. "Comparison of Endoscopic Hemostasis for Endoscopic Sphincterotomy Bleeding between a Novel Self-Assembling Peptide and Conventional Technique." Journal of Clinical Medicine 12, no. 1 (December 22, 2022): 79. http://dx.doi.org/10.3390/jcm12010079.
Abstract:
Introduction: Recently, a novel self-assembling peptide hemostatic gel has become available in Japan. However, the safety and efficacy of this novel self-assembling peptide hemostatic gel remain unclear for bleeding after EST. The aim of this study was to evaluate the safety and efficacy of a novel self-assembling peptide hemostatic gel for bleeding after EST, and to perform a comparison to a conventional endoscopic hemostasis technique. Method: This retrospective study was carried out between January 2019 and October 2022. Patients who developed bleeding associated with EST were enrolled. The patients were divided into two groups based on the hemostasis technique used: a conventional hemostasis technique (Group A) or a novel self-assembling peptide hemostatic gel hemostasis technique (Group B). Result: A total of 62 patients (Group A, n = 36; Group B, n = 26) were included. Endoscopic hemostasis was initially obtained in 72.2% (26/32) of patients in Group A and in 88.4% (23/26) of patients in Group B, which was not significantly different (p = 0.1320). However, the procedure time was significantly shorter in Group B (mean, 9.38 min) compared with Group A (mean, 15.4 min) (p = 0.0103). There were no significant differences in the severity of bleeding between the two groups (p = 0.4530). Post-EST bleeding was observed in six patients (Group A, n = 4; Group B, n = 2). Adverse events were more frequently observed in Group A (n = 12) than in Group B (n = 1) (p = 0.0457). Conclusions: PuraStat application for EST bleeding might be safe and effective, and is comparable to the conventional endoscopic hemostasis technique, although further prospective randomized trials are needed.
13
Chen, Yeyi, Lei Wu, Pengpeng Li, Xiao Hao, Xiao Yang, Guanghui Xi, Wen Liu, Yakai Feng, Hongchao He, and Changcan Shi. "Polysaccharide Based Hemostatic Strategy for Ultrarapid Hemostasis." Macromolecular Bioscience 20, no. 4 (February 18, 2020): 1900370. http://dx.doi.org/10.1002/mabi.201900370.
14
Cherednikov, Evgeniy, Igor Yuzefovich, Yuri Maleev, Sergey V. Barannikov Barannikov, Tatyana Litovkina, Galina Polubkova, and Evgeniy Ovsyannikov. "The Use of the Hemostatic Agent Zhelplastan in Combination with a Granulated Sorbent in the Treatment of Patients with Mallory-Weiss Syndrome." International Journal of Biomedicine 11, no. 2 (June 5, 2021): 160–63. http://dx.doi.org/10.21103/article11(2)_oa7.
Abstract:
Background: Mallory-Weiss syndrome (MWS) is one of the common causes of acute upper gastrointestinal bleeding. The aim of our research was to develop a method for the treatment of MWS, which would improve the efficiency of local hemostasis, reduce the risk of re-bleeding and shorten the treatment time. Methods and Results: The study involved 102 patients with MWS. All patients were divided by random sampling into two groups: the main group (MG) and control group (CG). Patients of both groups were comparable in age, gender, concomitant diseases, type of bleeding, size of bleeding defect, and duration of observations. The MG included 52 patients, who were given the developed method of MWS treatment. Patients with ongoing bleeding were treated with a combined method of endoscopic hemostasis: active bleeding was initially stopped by infiltration or coagulation (argon-plasma coagulation was preferred), and then to increase the reliability of hemostasis and prevent the resumption of bleeding, powdered Zhelplastan 0.2g was applied to the rupture area with an insufflator, followed by Sephadex G-25 0.3g (Patent RF №2633925). In patients with signs of unstable hemostasis, the developed method of cytoprotective action on a clot or thrombosed vessel was used by applying a local hemostatic, Zhelplastan 0.2g, to the defect area in combination with a granular sorbent, Sephadex G-25 0.3g, during therapeutic endoscopy to prevent the resumption of bleeding. In patients with stable stopped bleeding, a hemostatic powdered Zhelplastan was applied to the defect area using an endoscope in combination with Sephadex G-25, according to the developed method. In the CG (n=50), well-known methods of arresting endoscopic bleeding (pricking with aminocaproic acid, vasoconstrictors, argon-plasma coagulation, etc.) were used without local hemostatics and granular sorbents. Summing up the results of patients with Mallory-Weiss syndrome in the compared groups, in the MG final hemostasis was performed in 51(98.1%) patients. In the MG, bleeding resumed in 1(1.9%) patient. There were no emergency operations or deaths. In the CG, the bleeding was finally stopped in 43(86%) patients, and it resumed in 7(14%) patients. Emergency surgery was required for 1(2%) patient. In the CG, the mortality rate was 4%. Conclusion: In MWS, the use of the developed method of endoscopic treatment, including pneumoinsufflation of a powdered hemostatic agent in combination with a granular sorbent, against the background of conservative therapy, improved the results of treatment, increased the reliability of local hemostasis, reduced the number of recurrent bleedings, and excluded emergency operations.
15
Hussein, Mohamed, Durayd Alzoubaidi, Miguel-Fraile Lopez, Michael Weaver, Jacobo Ortiz-Fernandez-Sordo, Paul Bassett, Johannes W. Rey, et al. "Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer-related bleeding: multicenter international registry." Endoscopy 53, no. 01 (May 26, 2020): 36–43. http://dx.doi.org/10.1055/a-1186-5360.
Abstract:
Abstract Background Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and is associated with a 2 % – 17 % mortality rate in the UK and USA. Bleeding peptic ulcers account for 50 % of UGIB cases. Endoscopic intervention in a timely manner can improve outcomes. Hemostatic spray is an endoscopic hemostatic powder for GI bleeding. This multicenter registry was created to collect data prospectively on the immediate endoscopic hemostasis of GI bleeding in patients with peptic ulcer disease when hemostatic spray is applied as endoscopic monotherapy, dual therapy, or rescue therapy. Methods Data were collected prospectively (January 2016 – March 2019) from 14 centers in the UK, France, Germany, and the USA. The application of hemostatic spray was decided upon at the endoscopist’s discretion. Results 202 patients with UGIB secondary to peptic ulcers were recruited. Immediate hemostasis was achieved in 178/202 patients (88 %), 26/154 (17 %) experienced rebleeding, 21/175 (12 %) died within 7 days, and 38/175 (22 %) died within 30 days (all-cause mortality). Combination therapy of hemostatic spray with other endoscopic modalities had an associated lower 30-day mortality (16 %, P < 0.05) compared with monotherapy or rescue therapy. There were high immediate hemostasis rates across all peptic ulcer disease Forrest classifications. Conclusions This is the largest case series of outcomes of peptic ulcer bleeding treated with hemostatic spray, with high immediate hemostasis rates for bleeding peptic ulcers.
16
Lippi, Giuseppe, and Emmanuel J. Favaloro. "Laboratory hemostasis: from biology to the bench." Clinical Chemistry and Laboratory Medicine (CCLM) 56, no. 7 (June 27, 2018): 1035–45. http://dx.doi.org/10.1515/cclm-2017-1205.
Abstract:
AbstractPhysiological hemostasis is an intricate biological system, where procoagulant and anticoagulant forces interplay and preserves blood fluidity when blood vessels are intact, or trigger clot formation to prevent excessive bleeding when blood vessels are injured. The modern model of hemostasis is divided into two principal phases. The first, defined as primary hemostasis, involves the platelet-vessel interplay, whilst the second, defined as secondary hemostasis, mainly involves coagulation factors, damaged cells and platelet surfaces, where the so-called coagulation cascade rapidly develops. The activation and amplification of the coagulation cascade is finely modulated by the activity of several physiological inhibitors. Once bleeding has been efficiently stopped by blood clot formation, dissolution of the thrombus is essential to restore vessel permeability. This process, known as fibrinolysis, also develops through coordinate action of a vast array of proteins and enzymes. An accurate diagnosis of hemostasis disturbance entails a multifaceted approach, encompassing family and personal history of hemostatic disorders, accurate collection of clinical signs and symptoms, integrated with laboratory hemostasis testing. Regarding laboratory testing, a reasonable approach entails classifying hemostasis testing according to cost, complexity and available clinical information. Laboratory workout may hence initiate with some rapid and inexpensive “screening” tests, characterized by high negative predictive value, then followed by second- or third-line analyses, specifically aimed to clarify the nature and severity of bleeding or thrombotic phenotype. This article aims to provide a general overview of the hemostatic process, and to provide some general suggestions to optimally facilitate laboratory hemostasis testing.
17
Barg, Assaf, Ulrike Nowak-Göttl, and Gili Kenet. "Hemostasis in the Very Young." Seminars in Thrombosis and Hemostasis 44, no. 07 (June 18, 2018): 617–23. http://dx.doi.org/10.1055/s-0038-1660852.
Abstract:
AbstractHemostasis is a dynamic process that starts in utero. The coagulation system evolves with age, as evidenced by marked physiological differences in the concentration of the majority of hemostatic proteins in early life compared with adulthood. This concept, known as “developmental hemostasis,” has important biological and clinical implications. Overall, impaired platelet function, along with physiologically reduced levels of vitamin K–dependent and contact coagulation factors, may cause poorer clot firmness even in healthy neonates. However, increased activity of von Willebrand factor and low levels of coagulation inhibitors that promote hemostasis counterbalance the delicate and immature hemostatic system. Since this hemostatic system has little reserve capacity, preterm neonates or sick infants are extremely vulnerable and predisposed to either hemorrhagic or thrombotic complications. This review will address the concept and manifestations of developmental hemostasis with respect to clinical disease phenotypes. It will discuss bleeding diagnosis in neonates, dealing especially with the devastating complications of intracerebral and pulmonary hemorrhage in preterm infants. Neonates, especially the sickest preterm ones, are also extremely susceptible to thrombotic complications; thus, thrombosis in neonates will be reviewed, with special focus on arterial ischemic perinatal stroke. Based on the concept of developmental hemostasis, the phenotypes of clinically relevant bleeding or thrombotic disorders among neonates may differ from those of older infants and children. Treatment options for these conditions will be suggested and reviewed.
18
Borges-Vilches, Jessica, Claudio Aguayo, and Katherina Fernández. "The Effect on Hemostasis of Gelatin-Graphene Oxide Aerogels Loaded with Grape Skin Proanthocyanidins: In Vitro and In Vivo Evaluation." Pharmaceutics 14, no. 9 (August 25, 2022): 1772. http://dx.doi.org/10.3390/pharmaceutics14091772.
Abstract:
Using in vitro and in vivo models, this study investigated the hemostatic potential to control bleeding of both unloaded gelatin-graphene oxide aerogels and the same loaded with proanthocyanidins (PAs) from Vitis vinifera grape skin extract. Our results showed that the physicochemical and mechanical properties of the aerogels were not affected by PA inclusion. In vitro studies showed that PA-loaded aerogels increased the surface charge, blood absorption capacity and cell viability compared to unloaded ones. These results are relevant for hemostasis, since a greater accumulation of blood cells on the aerogel surface favors aerogel–blood cell interactions. Although PAs alone were not able to promote hemostasis through extrinsic and intrinsic pathways, their incorporation into aerogels did not affect the in vitro hemostatic activity of these composites. In vivo studies demonstrated that both aerogels had significantly increased hemostatic performance compared to SpongostanTM and gauze sponge, and no noticeable effects of PA alone on the in vivo hemostatic performance of aerogels were observed; this may have been related to its poor diffusion from the aerogel matrix. Thus, PAs have a positive effect on hemostasis when incorporated into aerogels, although further studies should be conducted to elucidate the role of this extract in the different stages of hemostasis.
19
Bruckner, Brian A., and Matthias Loebe. "Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures." Winter 9, no. 2 (August 8, 2012): 96–98. http://dx.doi.org/10.15420/usc.2012.9.2.96.
Abstract:
Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.
20
Park, Jin-Seok, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, and Don Haeng Lee. "Novel hemostatic adhesive powder for nonvariceal upper gastrointestinal bleeding." Endoscopy International Open 07, no. 12 (December 2019): E1763—E1767. http://dx.doi.org/10.1055/a-0982-3194.
Abstract:
Abstract Background and study aims A new hemostatic adhesive powder (UI-EWD) was developed to reduce high rebleeding rates and technical challenges associated with application of currently available hemostatic powders. The aim of the current study was to assess performance of UI-EWD for nonvariceal upper gastrointestinal bleeding (NVUGIB). Patients and methods A total of 56 consecutive patients that received UI-EWD monotherapy for endoscopic hemostasis due to NVUGIB were retrospectively reviewed. Main study outcomes were success rates with immediate hemostasis and rebleeding within 30 days. Outcomes were analyzed by reviewing patient medical records. Results Etiologies of bleeding were: post-endoscopic therapy bleeding in 46 (82.1 %), peptic ulcer in 8 (14.3 %), tumor in 1 (1.8 %), and other in 1 (1.8 %). UI-EWD was successfully applied at bleeding site in all cases. The success rate of immediate hemostasis was 96.4 % (54/56), and the 30-day rebleeding rate among patients that achieved immediate hemostasis was 3.7 % (2/54). No adverse event related to use of UI-EWD occurred. Conclusion UI-EWD was found to have a high immediate hemostasis success rate in NVUGIB when used as monotherapy and showed promising results in terms of preventing rebleeding.
21
Toubi, Elias, and Zahava Vadasz. "Hemostasis in Allergy." Seminars in Thrombosis and Hemostasis 44, no. 07 (June 19, 2018): 669–75. http://dx.doi.org/10.1055/s-0038-1648232.
Abstract:
AbstractThe involvement of the hemostatic system in immune-mediated inflammation is widely reported. Many coagulation factors play a role in the pathogenesis of autoimmune diseases, such as systemic vasculitis and systemic lupus erythematosus. Hemostatic disorders are also involved in asthma and chronic spontaneous urticaria (CSU). Factor XIIa (FXIIa) was one of the first coagulation factors implicated in inducing both humoral and cellular responses and is therefore considered a prime new therapeutic target in immune-mediated inflammation. The involvement of coagulation factors, such as tissue factor and fibrinogen, in the pathogenesis of asthma has been reported. The finding of platelet activation in asthma also indicates a link between bronchial inflammation and hemostasis. The pathogenesis of mast cell degranulation and CSU was also shown to be associated with the activation of hemostatic factors such as fibrinogen and FXIIa. Increased plasma levels of D-dimer have been widely reported as a biological marker for the duration and severity of CSU. In addition, endothelial-induced cell activation by the kallikrein–high molecular weight complex and the release of heat shock protein 90 was shown to be involved in mast cell degranulation disorders. In this narrative review, the authors aim to summarize the role of hemostasis in inflammation, asthma, and CSU by focusing on the increasing information linking hemostatic factors and immune-mediated disorders.
22
Reshetnyak, V. I., I. V. Maev, T. M. Reshetnyak, S. V. Zhuravel, and V. M. Pisarev. "Liver Diseases and the Hemostasis (Rewiew) Part 1. Non-Cholestatic Diseases of the Liver and Hemostasis." General Reanimatology 15, no. 5 (November 9, 2019): 74–87. http://dx.doi.org/10.15360/1813-9779-2019-5-74-87.
Abstract:
In liver diseases, most commonly in the terminal stage of liver failure, a variety of hemostatic defects affecting almost all parts of the blood coagulation system are developing. This leads to diminishing the capabilities of patients with liver diseases to correctly maintain the hemostatic balance.The severity of hemostatic disorders depends on the nosological form and degree of a liver damage. Depending on the imbalance of the hemostasis system and accumulated clinical/laboratory data, patients with liver diseases can be subdivided into three groups as exhibiting: 1. non-cholestatic liver damage; 2. cholestatic liver damage and 3. liver damage of vascular origin.The first part of the review discusses multiple alterations in the hemostasis system in patients with noncholestatic liver diseases, which are commonly accompanied by hypocoagulation.
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Zhang, Chen, Rui Zeng, Zhencheng Liao, Chaomei Fu, Hui Luo, Hanshuo Yang, and Yan Qu. "Bletilla striataMicron Particles Function as a Hemostatic Agent by Promoting Rapid Blood Aggregation." Evidence-Based Complementary and Alternative Medicine 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/5820405.
Abstract:
The human body cannot control blood loss without treatment. Available hemostatic agents are ineffective at treating cases of severe bleeding and are expensive or raise safety concerns.Bletilla striataserve as an inexpensive, natural, and promising alternative. However, no detailed studies on its hemostatic approach have been performed. The aim of this study was to examine the hemostatic effects ofB. striataMicron Particles (BSMPs) and their hemostatic mechanisms. We prepared and characterized BSMPs of different size ranges and investigated their use as hemostatic agent. BSMPs of different size ranges were characterized by scanning electron microscope. In vitro coagulation studies revealed BSMP-blood aggregate formation via stereoscope and texture analyzers. In vivo studies based on rat injury model illustrated the BSMP capabilities under conditions of hemostasis. Compared to other BSMPs of different size ranges, BSMPs of 350–250 μm are most efficient in hemostasis. As powder sizes decrease, the degree of aggregation between particles and hemostatic BSMP effects declines. The BSMP in contact with a bleeding surface locally forms a visible particle/blood aggregate as a physical barrier that facilitates hemostasis. Considering the facile preparation, low cost, and long shelf life ofB. striata, BSMPs offer great potential as mechanisms of trauma treatment.
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Sharma, Saurabh, Tejraj P. Kale, Lingaraj J. Balihallimath, and Abhishek Motimath. "Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs." Journal of Contemporary Dental Practice 18, no. 9 (2017): 802–6. http://dx.doi.org/10.5005/jp-journals-10024-2130.
Abstract:
ABSTRACT Aim The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy. Materials and methods Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis. Results Extraction sites treated with Axiostat Hemostatic Dressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control. Conclusion Axiostat demonstrated to be an effective hemostatic agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy. Clinical significance The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain. How to cite this article Sharma S, Kale TP, Balihallimath LJ, Motimath A. Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs. J Contemp Dent Pract 2017;18(9):802-806.
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Chapman, William C., Sherry M. Wren, Gail S. Lebovic, Martin Malawer, Randolph Sherman, and Jon E. Block. "Effective Management of Bleeding during Tumor Resection with a Collagen-Based Hemostatic Agent." American Surgeon 68, no. 9 (September 2002): 802–7. http://dx.doi.org/10.1177/000313480206800914.
Abstract:
In a prospective controlled trial hemostatic effectiveness of a novel collagen-based composite (CoStasis®) was compared with a collagen sponge applied with manual pressure at diffusely bleeding sites after surgical tumor resection. The proportion of subjects achieving complete cessation of bleeding within 10 minutes (i.e., hemostatic success) and the time to “complete hemostasis” were determined at raw surgical sites after tumor resection among 23 experimental and 30 control subjects. There was a similar distribution in tumor types (e.g., benign vs malignant) evaluated between treatment groups. A significantly greater proportion of experimental subjects achieved complete hemostasis within 10 minutes of observation compared with controls [23 of 23 (100%) vs 21 of 30 (70%); P = 0.003]. The median time required to achieve complete hemostasis was more than three times longer for subjects treated with the collagen sponge compared with subjects treated with CoStasis® (243 vs 78 seconds; P = 0.0001). Approximately 80 per cent of experimental subjects achieved complete hemostasis within 2 minutes compared with only 35 per cent of controls. There were no adverse events related to the experimental treatment in this study. These results support the use of this novel hemostatic agent to control diffuse surgical site bleeding after tumor resection at diverse anatomical locations.
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Ali-Mohamad, Nabil, Massimo Cau, James Baylis, Veronika Zenova, Hugh Semple, Andrew Beckett, Andrew McFadden, Fergal Donnellan, and Christian Kastrup. "Severe upper gastrointestinal bleeding is halted by endoscopically delivered self-propelling thrombin powder: A porcine pilot study." Endoscopy International Open 09, no. 05 (April 22, 2021): E693—E698. http://dx.doi.org/10.1055/a-1374-5839.
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Abstract Background and study aims Hemostatic powders have emerged recently to treat upper gastrointestinal bleeding (UGIB). Previously, we developed a novel self-propelling thrombin powder (SPTP) that effectively manages external pulsatile arterial bleed without compression, by effervescing and carrying thrombin into the wound. Here, we tested if SPTP, sprayed endoscopically, can manage severe UGIB in a live porcine model. Materials and methods Anesthetized pigs underwent laparotomy to insert the gastroepiploic vascular bundles into the stomach lumen via a gastrotomy. Bleeding was initiated endoscopically in the stomach by needle knife. SPTP was delivered to the site of bleeding from a CO2-powered spray device using a 7 FR catheter. Successful primary hemostasis, time to hemostasis, and the mass of SPTP delivered were measured. Results Hemostasis was achieved at all bleeding sites using SPTP. Mean time to hemostasis was 4.2 ± 0.9 minutes (mean ± standard error of the mean, n = 12). The average mass of SPTP delivered was 2.4 ± 0.6 g. Conclusions In this pilot study, SPTP successfully stopped 12 cases of severe UGIB, demonstrating early promise asa novel hemostatic powder.
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Fan, Peng, Yanbo Zeng, Dionisio Zaldivar-Silva, Lissette Agüero, and Shige Wang. "Chitosan-Based Hemostatic Hydrogels: The Concept, Mechanism, Application, and Prospects." Molecules 28, no. 3 (February 3, 2023): 1473. http://dx.doi.org/10.3390/molecules28031473.
Abstract:
The design of new hemostatic materials to mitigate uncontrolled bleeding in emergencies is challenging. Chitosan-based hemostatic hydrogels have frequently been used for hemostasis due to their unique biocompatibility, tunable mechanical properties, injectability, and ease of handling. Moreover, chitosan (CS) absorbs red blood cells and activates platelets to promote hemostasis. Benefiting from these desired properties, the hemostatic application of CS hydrogels is attracting ever-increasing research attention. This paper reviews the recent research progress of CS-based hemostatic hydrogels and their advantageous characteristics compared to traditional hemostatic materials. The effects of the hemostatic mechanism, effects of deacetylation degree, relative molecular mass, and chemical modification on the hemostatic performance of CS hydrogels are summarized. Meanwhile, some typical applications of CS hydrogels are introduced to provide references for the preparation of efficient hemostatic hydrogels. Finally, the future perspectives of CS-based hemostatic hydrogels are presented.
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Adili, Reheman, Madeline Jackson, Livia Stanger, Xiangrong Dai, Mandy Li, Benjamin Xiaoyi Li, and Michael Holinstat. "Slounase, a Batroxobin Containing Activated Factor X Effectively Enhances Hemostatic Clot Formation and Reducing Bleeding in Hypocoagulant Conditions in Mice." Clinical and Applied Thrombosis/Hemostasis 27 (January 1, 2021): 107602962110185. http://dx.doi.org/10.1177/10760296211018510.
Abstract:
Uncontrolled bleeding associated with trauma and surgery is the leading cause of preventable death. Batroxobin, a snake venom-derived thrombin-like serine protease, has been shown to clot fibrinogen by cleaving fibrinopeptide A in a manner distinctly different from thrombin, even in the presence of heparin. The biochemical properties of batroxobin and its effect on coagulation have been well characterized in vitro. However, the efficacy of batroxobin on hemostatic clot formation in vivo is not well studied due to the lack of reliable in vivo hemostasis models. Here, we studied the efficacy of batroxobin and slounase, a batroxobin containing activated factor X, on hemostatic clot composition and bleeding using intravital microcopy laser ablation hemostasis models in micro and macro vessels and liver puncture hemostasis models in normal and heparin-induced hypocoagulant mice. We found that prophylactic treatment in wild-type mice with batroxobin, slounase and activated factor X significantly enhanced platelet-rich fibrin clot formation following vascular injury. In heparin-treated mice, batroxobin treatment resulted in detectable fibrin formation and a modest increase in hemostatic clot size, while activated factor X had no effect. In contrast, slounase treatment significantly enhanced both platelet recruitment and fibrin formation, forming a stable clot and shortening bleeding time and blood loss in wild-type and heparin-treated hypocoagulant mice. Our data demonstrate that, while batroxobin enhances fibrin formation, slounase was able to enhance hemostasis in normal mice and restore hemostasis in hypocoagulant conditions via the enhancement of fibrin formation and platelet activation, indicating that slounase is more effective in controlling hemorrhage.
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Hwang, Yeok Gu, Jin Woo Lee, Eun Ae Won, and Seung Hwan Han. "Prospective Randomized Controlled Study of Hemostatic Efficacy with Kaolin-Impregnated Dressings in Diabetic Foot Ulcers Taking Anticoagulants Undergoing Debridement in an Outpatient Clinic." Journal of Diabetes Research 2019 (November 11, 2019): 1–6. http://dx.doi.org/10.1155/2019/9316380.
Abstract:
Background. The effective hemostasis after minor debridement in an outpatient clinic is important and essential. This study is aimed at evaluating the hemostatic efficacy and safety of the kaolin-impregnated dressing for diabetic foot ulcer patient who take an anticoagulant. Methods. A prospective, randomized, clinical trial study was performed in twenty-six patients with diabetic foot ulcers who take an anticoagulant requiring minor debridement in an outpatient clinic. Minor debridement and removal of break down skin were performed by one orthopedic surgeon. Hemostasis on wound bed was achieved using kaolin-impregnated gauze (study group) and standard sterilized dry gauze (control group). Two randomized groups were compared for hemostatic efficacy and side effect. Results. For the purpose of this study, the presence or absence of hemostasis was assessed at 5 and 10 minutes after the application of dressing material. Treatment was evaluated as successful if bleeding was ceased adequately, and no extra hemostatic measures were required within 10 minutes. At 5 minutes, 80% of patients using the kaolin-impregnated gauze successfully achieved complete hemostasis versus 40% in the control group that controlled bleeding partially. With kaolin-impregnated gauze, 100% of patients show complete hemostasis at 10 minutes versus 58.3% in the standard gauze (P<.001). An adverse effect was not noted in all patients. Conclusions. The use of kaolin-impregnated gauze appears to be a safe and feasible option in managing bleeding after debridement of diabetic foot ulcers, and merits to patient who had a bleeding tendency is high. This trial is registered with CRIS registration number KCT0003894.
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Matsubara, Makoto, Masataka Banshodani, Akira Takahashi, Yusuke Kawai, Tomoki Saiki, Masahiro Yamashita, Nobuaki Shiraki, et al. "Vascular access management after percutaneous transluminal angioplasty using a calcium alginate sheet: a randomized controlled trial." Nephrology Dialysis Transplantation 34, no. 9 (May 28, 2018): 1592–96. http://dx.doi.org/10.1093/ndt/gfy143.
Abstract:
Abstract Background Management of vascular access (VA) is essential in hemodialysis (HD) patients. However, VA often fails and percutaneous transluminal angioplasty (PTA) is required. Conventional hemostasis at the puncture site is associated with complications. This study aimed to analyze the efficacy and safety of a hemostatic wound dressing made of calcium alginate at the puncture site of VA after PTA and evaluate other factors affecting hemostasis. Methods After PTA for VA, 200 HD patients were randomized to a calcium alginate sheet (CA) group (n = 100) or a no drug-eluting sheet (control) group (n = 100). We recorded time to hemostasis at the puncture site every 5 min, noting any complications. Results In the CA group, rates of hemostatic achievement at 5, 10, 15 and >15 min were 57, 25, 8 and 10%, respectively. In the control group, the rates were 39, 28, 14 and 19%, respectively. Rates of hemostatic achievement at 5 min were significantly higher in the CA group (P = 0.01). In logistic regression analysis, factors affecting hemostasis within 5 min were use of the CA sheet [odds ratio (OR) 2.33; 95% confidence interval (CI) 1.26–4.37], platelet count ≤100 000/μL (OR 0.19; 95% CI 0.04–0.69), number of antithrombotic tablets used per day ≥1 tablet (OR 0.50; 95% CI 0.26–0.94) and upper arm VA (OR 0.16; 95% CI 0.03–0.55). Conclusions A CA sheet can safely reduce time to hemostasis at the puncture site after PTA, and should be considered for treating patients with a bleeding tendency.
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de Nucci, Germana, Raffaella Reati, Ilaria Arena, Cristina Bezzio, Massimo Devani, Cristina della Corte, Daniela Morganti, et al. "Efficacy of a novel self-assembling peptide hemostatic gel as rescue therapy for refractory acute gastrointestinal bleeding." Endoscopy 52, no. 09 (April 21, 2020): 773–79. http://dx.doi.org/10.1055/a-1145-3412.
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Abstract Background Acute gastrointestinal bleeding (AGIB) results in significant morbidity and mortality. Topical hemostatic products have been developed for endoscopic use to help in the management of difficult bleeding. Our aim was to demonstrate the ease of use, safety, and efficacy of PuraStat, a novel hemostat, to control AGIB. Methods We describe 77 patients (41 men) who were treated for acute upper and lower AGIB in a 2-year period. In 50 patients, bleeding occurred as a complication of a previous endoscopic procedure, predominantly endoscopic mucosal resection (EMR) and endoscopic retrograde cholangiopancreatography (ERCP); however, in the other 27 patients, it derived from peptic ulcers, angiodysplasia, cancers, and surgical anastomoses. Bleeding was spurting in 13 of the 77 patients and oozing in 64. PuraStat was used after the failure of at least two conventional hemostatic methods. Results A mean of 2.6 conventional hemostatic methods had been attempted prior to the application of PuraStat. PuraStat achieved successful hemostasis in 90.9 % of patients. In 41 patients, once hemostasis was obtained with PuraStat, endoscopists further stabilized hemostasis by using at least one additional method. Recurrence of bleeding was observed in eight patients (10.4 %). In 16 patients with intraprocedural bleeding, it was possible to complete the procedures (14 EMR, 2 ERCP) after PuraStat hemostasis. No adverse events related to PuraStat were recorded. Conclusions PuraStat is feasible, safe, and effective in controlling different types of gastrointestinal hemorrhage after failure of conventional hemostatic methods. Its application also does not hinder continuing endotherapy.
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Bertrand, Olivier F., and Zoltan Ruzsa. "Hemostatic Patch for Accelerated Hemostasis After Transradial Procedures." JACC: Cardiovascular Interventions 15, no. 8 (April 2022): 820–22. http://dx.doi.org/10.1016/j.jcin.2022.03.006.
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Tohata, Misako, Yorimasa Yamamoto, Masafumi Hayashi, Shotaro Hanamura, Kuniyo Gomi, Tetsushi Azami, Kenta Iwahashi, et al. "Endoscopic hemostasis using hemostatic forceps for duodenal bleeding." Progress of Digestive Endoscopy 92, no. 1 (June 15, 2018): 80–81. http://dx.doi.org/10.11641/pde.92.1_80.
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Green, David, Cynthia A. Wong, and Przemyslaw Twardowski. "Efficacy of hemostatic agents in improving surgical hemostasis." Transfusion Medicine Reviews 10, no. 3 (July 1996): 171–82. http://dx.doi.org/10.1016/s0887-7963(96)80058-7.
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de la Torre, Roger A., Sharon L. Bachman, Andrew A. Wheeler, Kevin N. Bartow, and J. Stephen Scott. "Hemostasis and hemostatic agents in minimally invasive surgery." Surgery 142, no. 4 (October 2007): S39—S45. http://dx.doi.org/10.1016/j.surg.2007.06.023.
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Andrew, Maureen. "Developmental Hemostasis: Relevance to Hemostatic Problems During Childhood." Seminars in Thrombosis and Hemostasis 21, no. 04 (October 1995): 341–56. http://dx.doi.org/10.1055/s-2007-1000655.
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Roberts, Lara N. "Rebalanced hemostasis in liver disease: a misunderstood coagulopathy." Hematology 2021, no. 1 (December 10, 2021): 485–91. http://dx.doi.org/10.1182/hematology.2021000283.
Abstract:
Abstract The combination of frequently abnormal hemostatic markers and catastrophic bleeding as seen with variceal hemorrhage has contributed to the longstanding misperception that chronic liver disease (CLD) constitutes a bleeding diathesis. Laboratory studies of hemostasis in liver disease consistently challenge this with global coagulation assays incorporating activation of the protein C pathway demonstrating rebalanced hemostasis. It is now recognized that bleeding in CLD is predominantly secondary to portal hypertension (rather than a coagulopathy) and additionally that these patients are at increased risk of venous thrombosis, particularly in the portal venous system. This narrative review describes the current understanding of hemostasis in liver disease, as well as the periprocedural management of hemostasis and anticoagulation for management of venous thromboembolism in patients with CLD.
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Clapp, Mara, and Jaou-Chen Huang. "Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy." Case Reports in Obstetrics and Gynecology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/906825.
Abstract:
Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.
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Denisov, A. V., A. M. Nosov, S. Yu Telitskii, and K. N. Demchenko. "Assessing effectiveness of topical hemostatic chitosan-based agents in experiments." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 3 (September 28, 2018): 65–72. http://dx.doi.org/10.25016/2541-7487-2018-0-3-65-72.
Abstract:
Relevance.Persistent profuse external hemorrhage is known to be one of the main causes of death in combat casualties.Intention.To evaluate experimentally the effectiveness of new chitosan-based topical hemostatic agents (THA) in various models of profuse external arterial hemorrhage.Method.New hemostatic chitosan-based agents of Hemohit type in various pharmaceutical dosage forms (Hemohit powder, 20 g per package and Hemohit-applicator [fine chitosan powder Hemohit-A or chitosan granules Hemohit-AG 6 g in the syringe-applicator]) were assessed for effectiveness in the model of profuse external arterial hemorrhage (bevelled laceration of the femoral artery) in 10 large laboratory animals (pigs). Evaluation of the THA effectiveness was performed according to the following parameters: primary hemostasis – stopping of bleeding immediately after application of the 1st THA package and application of a pressure bandage; secondary haemostasis – stopping bleeding immediately after applying the 2nd THA package and applying a pressure bandage, if the 1st THA package is ineffective; final hemostasis – no bleeding within 3 hours of follow-up; absence / resumption of bleeding after the march test; total amount of blood loss during the experiment; survival.Result and their analysis. It was experimentally found that in the case of external profuse arterial hemorrhage the powder and the syringe-applicator provided permanent hemostasis and 100 % animal survival. In two cases out of four, a second package of Hemohit powder was required for the final stop of bleeding. The bleeding stopped due to the formation of an edge thrombus in the area of the vascular wall defect.Conclusion.Hemohit THA can effectively stop arterial bleeding. The effectiveness of applicator with local hemostats can be assessed in the proposed experimental model with a deep narrow wound canal and femoral artery damage.
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Xie, Yue, Pan Gao, Fangfang He, and Chun Zhang. "Application of Alginate-Based Hydrogels in Hemostasis." Gels 8, no. 2 (February 10, 2022): 109. http://dx.doi.org/10.3390/gels8020109.
Abstract:
Hemorrhage, as a common trauma injury and clinical postoperative complication, may cause serious damage to the body, especially for patients with huge blood loss and coagulation dysfunction. Timely and effective hemostasis and avoidance of bleeding are of great significance for reducing body damage and improving the survival rate and quality of life of patients. Alginate is considered to be an excellent hemostatic polymer-based biomaterial due to its excellent biocompatibility, biodegradability, non-toxicity, non-immunogenicity, easy gelation and easy availability. In recent years, alginate hydrogels have been more and more widely used in the medical field, and a series of hemostatic related products have been developed such as medical dressings, hemostatic needles, transcatheter interventional embolization preparations, microneedles, injectable hydrogels, and hemostatic powders. The development and application prospects are extremely broad. This manuscript reviews the structure, properties and history of alginate, as well as the research progress of alginate hydrogels in clinical applications related to hemostasis. This review also discusses the current limitations and possible future development prospects of alginate hydrogels in hemostatic applications.
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Hu, Zhang, Dong-Ying Zhang, Si-Tong Lu, Pu-Wang Li, and Si-Dong Li. "Chitosan-Based Composite Materials for Prospective Hemostatic Applications." Marine Drugs 16, no. 8 (August 4, 2018): 273. http://dx.doi.org/10.3390/md16080273.
Abstract:
Effective hemostasis is vital to reduce the pain and mortality of patients, and the research and development of hemostatic materials are prerequisite for effective hemostasis. Chitosan (CS), with good biodegradability, biocompatibility and non-toxicity, has been widely applied in bio-medicine, the chemical industry, the food industry and cosmetics. The excellent hemostatic properties of CS have been extensively studied. As a result, chitosan-based composite hemostatic materials have been emerging. In this review, the hemostatic mechanism of chitosan is briefly discussed, and then the progress of research on chitosan-based composite hemostatic materials with multiple forms such as films, sponges, hydrogels, particles and fibers are introduced. Finally, future perspectives of chitosan-based composite hemostatic materials are given. The objective of this review is to provide a reference for further research and development of effective hemostatic materials.
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Krapivina, Elena V., and Tatyana V. Novikova. "Functional features of hemostasis in physically weakened newborn piglets and calves." BIO Web of Conferences 17 (2020): 00162. http://dx.doi.org/10.1051/bioconf/20201700162.
Abstract:
The normal state of hematological parameters in mammals at the beginning of ontogenesis is rightfully considered to be functionally very significant for the development of early ontogenesis in them. Hemostasis is considered to be very significant for vital functions and vulnerable blood systems. Its condition affects trophism due to the effect on the state of microcirculation, which is very important at the beginning of ontogenesis. In the neonatal phase, calves and piglets develop the formation of hemostasis and therefore, during these periods it can be easily disrupted. The appearance of hemostatic dysfunctions in the body of young animals, despite its importance, is still very poorly studied. This circumstance was the motivation for the study of the activity of the hemostatic system in calves and piglets that were born physically weakened. It was found that immediately after birth in weakened calves and piglets, there are physiologically unfavorable changes in platelet activity, vascular hemostasis and blood coagulation. This provides them with the appearance of excessive platelet activity and blood clotting with a significant weakening of vascular hemostasis. All these disorders lead to negative changes in their internal organs and create their serious dysfunctions. The development of disorders in the mechanisms of hemostasis in physically weakened calves and piglets during the neonatal phase is a serious mechanism for weakening their adaptation to the environment and slowing the growth and development of animals.
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Yada, Koji, and Keiji Nogami. "Novel Insights and New Developments Regarding Coagulation Revealed by Studies of the Anti-Factor IXa (Activated Factor IX)/Factor X Bispecific Antibody, Emicizumab." Arteriosclerosis, Thrombosis, and Vascular Biology 40, no. 5 (May 2020): 1148–54. http://dx.doi.org/10.1161/atvbaha.120.312919.
Abstract:
Emicizumab is a humanized anti-FIXa/FX (factor IXa/X) bispecific monoclonal antibody that mimics FVIIIa (activated factor VIII) cofactor function. The hemostatic efficacy of emicizumab has been confirmed in clinical studies of patients with hemophilia A, irrespective of the presence of FVIII inhibitors. Emicizumab differs in some properties from FVIIIa molecule. Emicizumab requires no activation by thrombin and is not inactivated by activated protein C, but emicizumab-mediated coagulation is regulatable and maintains hemostasis. A small amount of FIXa (activated factor IX) is required to initiate emicizumab-mediated hemostasis, whereas tissue factor/FVIIa (activated factor VII)-mediated FXa (activated factor X) and thrombin activation initiates FVIIIa-mediated hemostasis. Fibrin formation, followed by fibrinolysis, appears to be similar between emicizumab- and FVIIIa-mediated hemostasis. These results suggest possible future uses of emicizumab for treating hemorrhagic diseases other than hemophilia A and reveal previously unobservable behaviors of procoagulation and anticoagulation factors in conventional hemostasis. Here, we have reviewed novel insights and new developments regarding coagulation highlighted by emicizumab.
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Hua, Nadia, Alexandra Elizabeth Quimby, and Stephanie Johnson-Obaseki. "Comparing Hematoma Incidence between Hemostatic Devices in Total Thyroidectomy: A Systematic Review and Meta-analysis." Otolaryngology–Head and Neck Surgery 161, no. 5 (July 23, 2019): 770–78. http://dx.doi.org/10.1177/0194599819865248.
Abstract:
Objective Alternative energy devices have become a popular alternative to conventional hemostasis in thyroid surgery. These devices have been shown to reduce operative time and thermal nerve injury. As hemostasis is paramount in thyroid surgery, we sought to examine the relative efficacy of 2 alternate energy devices compared to conventional hemostasis in preventing postoperative hematoma following total thyroidectomy. Data Sources Ovid MEDLINE, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials. Review Methods A systematic literature search was performed for all relevant English-language studies published between 1946 and July 2018. Two authors independently extracted data and analyzed articles for quality using the National Institute of Health Quality Assessment Scale. Our primary outcome of interest was hematoma requiring reoperation. Results A total of 348 studies were screened, with 23 meeting the inclusion criteria. We found no significant difference in postoperative hematoma rates using alternate energy devices compared to conventional hemostasis ( P = .370, .317). Network meta-analysis echoed the results of conventional meta-analysis, demonstrating no significant difference in hematoma rates. Conclusions We found no significant difference in postoperative hematoma rates following total thyroidectomy for any indication with the use of alternate energy devices compared to conventional hemostatic techniques. This suggests that hematoma occurrence does not necessarily need to be considered when choosing between these hemostatic devices. This information may help guide surgeons’ decisions regarding choice of hemostatic technique during thyroid surgery.
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Shopnick, Rinah I., and Doreen B. Brettler. "Hemostasis." Clinical Orthopaedics and Related Research 328 (July 1996): 34–38. http://dx.doi.org/10.1097/00003086-199607000-00008.
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Kretschmer, Volker, Ralf Karger, Jean-François Hardy, and Thomas Lecompte. "Hemostasis." Transfusion Alternatives in Transfusion Medicine 6, s1 (March 2004): 37–40. http://dx.doi.org/10.1111/j.1778-428x.2004.tb00141.x.
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Chivukula, Srinivas, Gregory M. Weiner, and Johnathan A. Engh. "The early days of hemostasis in neurosurgery." Neurosurgical Focus 36, no. 4 (April 2014): E5. http://dx.doi.org/10.3171/2014.1.focus13565.
Abstract:
Two key discoveries in the 19th century—infection control and the development of general anesthesia—provided an impetus for the rapid advancement of surgery, especially within the field of neurosurgery. Yet the field of neurosurgery would not have existed in the modern sense without the development and advancement of techniques in hemostasis. Improvement in intraoperative hemostasis came more gradually but was no less important to enhancing neurosurgical outcomes. The history of hemostasis in neurosurgery is often overlooked. Herein, the authors briefly review the historical progression of hemostatic techniques since the beginning of the early modern era of neurosurgery.
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Dadeko, S. M., Ye G. Ripp, V. Ye Shipakov, V. O. Sorokozherdiev, O. N. Popadeikin, and V. V. Solov’Yov. "Influence of different methods of anesthesia on hemostasis systemin proctological patients." Bulletin of Siberian Medicine 7, no. 2 (June 30, 2008): 95–100. http://dx.doi.org/10.20538/1682-0363-2008-2-95-100.
Abstract:
The aim of investigation is to study the influence of different types of anesthesia on hemostasis in proctological patients, and to develop the algorithm to determine adequate method of anesthesia to prevent hemostatic disorders. 120 patients have been investigated with new instrumental method — hemocoagulography. It has been estimated that different types of anesthesia have different influence on functional activity of hemostasis.
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Sultan, Md Tipu, Heesun Hong, Ok Joo Lee, Olatunji Ajiteru, Young Jin Lee, Ji Seung Lee, Hanna Lee, Soon Hee Kim, and Chan Hum Park. "Silk Fibroin-Based Biomaterials for Hemostatic Applications." Biomolecules 12, no. 5 (April 30, 2022): 660. http://dx.doi.org/10.3390/biom12050660.
Abstract:
Hemostasis plays an essential role in all surgical procedures. Uncontrolled hemorrhage is the primary cause of death during surgeries, and effective blood loss control can significantly reduce mortality. For modern surgeons to select the right agent at the right time, they must understand the mechanisms of action, the effectiveness, and the possible adverse effects of each agent. Over the past decade, various hemostatic agents have grown intensely. These agents vary from absorbable topical hemostats, including collagen, gelatins, microfibrillar, and regenerated oxidized cellulose, to biologically active topical hemostats such as thrombin, biological adhesives, and other combined agents. Commercially available products have since expanded to include topical hemostats, surgical sealants, and adhesives. Silk is a natural protein consisting of fibroin and sericin. Silk fibroin (SF), derived from silkworm Bombyx mori, is a fibrous protein that has been used mostly in fashion textiles and surgical sutures. Additionally, SF has been widely applied as a potential biomaterial in several biomedical and biotechnological fields. Furthermore, SF has been employed as a hemostatic agent in several studies. In this review, we summarize the several morphologic forms of SF and the latest technological advances on the use of SF-based hemostatic agents.
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Ji, Yuexin, Wenliang Song, Lin Xu, Deng-Guang Yu, and Sim Wan Annie Bligh. "A Review on Electrospun Poly(amino acid) Nanofibers and Their Applications of Hemostasis and Wound Healing." Biomolecules 12, no. 6 (June 7, 2022): 794. http://dx.doi.org/10.3390/biom12060794.
Abstract:
The timely and effective control and repair of wound bleeding is a key research issue all over the world. From traditional compression hemostasis to a variety of new hemostatic methods, people have a more comprehensive understanding of the hemostatic mechanism and the structure and function of different types of wound dressings. Electrospun nanofibers stand out with nano size, high specific surface area, higher porosity, and a variety of complex structures. They are high-quality materials that can effectively promote wound hemostasis and wound healing because they can imitate the structural characteristics of the skin extracellular matrix (ECM) and support cell adhesion and angiogenesis. At the same time, combined with amino acid polymers with good biocompatibility not only has high compatibility with the human body but can also be combined with a variety of drugs to further improve the effect of wound hemostatic dressing. This paper summarizes the application of different amino acid electrospun wound dressings, analyzes the characteristics of different materials in preparation and application, and looks forward to the development of directions of poly(amino acid) electrospun dressings in hemostasis.