非压迫性躯干出血(NCTH)和内出血治疗方法的综述。
A review of treatments for non-compressible torso hemorrhage (NCTH) and internal bleeding.
机构信息
Chemical Engineering, United States; Institute for Soldier Nanotechnologies, United States.
Chemical Engineering, United States; Institute for Soldier Nanotechnologies, United States; Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States.
出版信息
Biomaterials. 2022 Apr;283:121432. doi: 10.1016/j.biomaterials.2022.121432. Epub 2022 Feb 21.
Non-compressible torso hemorrhage (NCTH) is associated with significant mortality in preventable deaths, both in the field and in civilian settings. Current management strategies of these injuries include fluid resuscitation, the use of foaming materials to occlude damaged vessels, and fibrin sealants. Researchers in the field have proposed multiple alternatives to these treatments, such as hemostatic sponges, self-assembling peptide materials, in situ crosslinking hydrogels, and intravenous nanoparticles, which are then challenged in a wide variety of injury models to evaluate their efficacy. This review first discusses the treatment of NCTH in the clinic and field before providing an overview of materials in literature designed for this same purpose, with the intention of summarizing the treatment options and research currently available in this field. The mechanisms of these hemostats, as well as their effectiveness in promoting hemostasis (evaluated through survival, bleeding time, and blood loss volume) are summarized side-by-side for easy comparison across various studies and animal models. Ultimately, a better understanding of existing technologies and the metrics through which they are evaluated may facilitate the development of safer, more effective therapies for non-compressible torso hemorrhage and internal bleeding.
非压迫性躯干出血(NCTH)与可预防死亡中的显著死亡率相关,无论是在现场还是在平民环境中。目前这些损伤的治疗策略包括液体复苏、使用泡沫材料堵塞受损血管以及纤维蛋白密封剂。该领域的研究人员已经提出了多种这些治疗方法的替代品,例如止血海绵、自组装肽材料、原位交联水凝胶和静脉内纳米颗粒,然后在广泛的损伤模型中对这些替代品进行了挑战,以评估它们的疗效。本综述首先讨论了临床和现场治疗 NCTH 的方法,然后概述了为解决同一问题而设计的文献中的材料,旨在总结该领域目前可用的治疗方案和研究。这些止血剂的作用机制及其在促进止血方面的有效性(通过存活率、出血时间和失血量来评估)并排进行总结,以便在各种研究和动物模型中进行轻松比较。最终,对现有技术的深入了解以及评估它们的指标可能有助于开发更安全、更有效的非压迫性躯干出血和内部出血治疗方法。