Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding.

Autor: Hickman DA; Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA., Pawlowski CL; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA., Sekhon UDS; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA., Marks J; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA., Gupta AS; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
Jazyk: angličtina
Zdroj: Advanced materials (Deerfield Beach, Fla.) [Adv Mater] 2018 Jan; Vol. 30 (4). Date of Electronic Publication: 2017 Nov 22.
DOI: 10.1002/adma.201700859
Abstrakt: Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed.
(© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)
Databáze: MEDLINE
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