Nanosciences and Technology Department, National Centre for Physics, Quaid-i-Azam University Campus, Islamabad, Pakistan.
Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan.
J Biomed Mater Res B Appl Biomater. 2021 Oct;109(10):1465-1477. doi: 10.1002/jbm.b.34806. Epub 2021 Jan 28.
Uncontrolled bleeding remains the leading cause of morbidity and mortality across the entire macrocosm. It refers to excessive loss of blood that occurs inside of body, due to unsuccessful platelet plug formation at the injury site. It is not only limited to the battlefield, but remains the second leading cause of death amongst the civilians, as a result of traumatic injury. Startlingly, there are no effective treatments currently available, to cater the issue of internal bleeding, even though early intervention is of utmost significance in minimizing the mortality rates associated with it. The fatal issue of uncontrolled bleeding is ineffectively being dealt with the use of pressure dressings, tourniquet, and surgical procedures. This is not a practical approach in combat arenas or in emergency situations, where the traumatic injury inflicted is deep inside the body, and cannot be addressed externally, by the application of topical dressings. This review focuses on the traditional hemostatic agents that are used to augment the process of hemostasis, such as mineral zeolites, chitosan based products, biologically active agents, anti-fibrinolytics, absorbable agents, and albumin and glutaraldehyde, as well as the micro- and nano-based hemostatic agents such as synthocytes, thromboerythrocytes, thrombosomes, and the synthetic platelets.
失控性出血仍然是整个宏观世界发病率和死亡率的主要原因。它是指由于受伤部位血小板栓形成不成功而导致的体内血液过多流失。它不仅限于战场，而且仍然是平民因创伤而导致的第二大致死原因。令人震惊的是，目前尚无有效的治疗方法来解决内部出血问题，尽管早期干预对于降低与之相关的死亡率至关重要。使用压力敷料、止血带和手术程序来处理失控性出血这一致命问题并不实际。在战斗场所以及紧急情况下，这种方法是不切实际的，因为受伤的部位在体内深处，无法通过外部应用敷贴来处理。本综述重点介绍了用于增强止血过程的传统止血剂，例如沸石矿物、壳聚糖基产品、生物活性剂、抗纤维蛋白溶解剂、可吸收剂以及白蛋白和戊二醛，以及微纳米基止血剂，例如合成细胞、血栓红细胞、血栓体和合成血小板。
