新型四聚乙二醇水凝胶的止血能力

Hemostatic Capability of a Novel Tetra-Polyethylene Glycol Hydrogel.

作者信息

Okata Shinya, Hoshina Katsuyuki, Hanada Kazumasa, Kamata Hiroyuki, Fujisawa Ayano, Yoshikawa Yuki, Sakai Takamasa

机构信息

Department of Vascular Surgery, The University of Tokyo, Tokyo, Japan.

出版信息

Ann Vasc Surg. 2022 Aug;84:398-404. doi: 10.1016/j.avsg.2022.01.016. Epub 2022 Mar 4.

DOI:10.1016/j.avsg.2022.01.016

PMID:35257910

Abstract

BACKGROUND

TetraStat is a tetra-armed polyethylene glycol (PEG) hydrogel. It is a synthetic sealant that solidifies instantly in response to pH changes. This study aimed to evaluate the hemostatic effect of TetraStat through experiments evaluating future clinical applications.

METHODS

We used TetraStat, oxidized regenerated cellulose (SURGICEL®), and fibrinogen and thrombin sealant patch (TachoSil®) using in vitro and in vivo experiments. For the in vitro experiment, a closed circulatory system filled with phosphate-buffered saline under high pressure was used. Needle punctures were created and closed using the various sealants. For the in vivo experiment, rat venae cavae were punctured with 18- and 20-gauge (G) needles, and hemorrhage was allowed to occur for several seconds. A porous PEG sponge soaked with TetraStat was applied as a hemostatic system. Hemostasis outcomes were compared among the various concentrations (40-100 g/L) of TetraStat, SURGICEL, and TachoSil.

RESULTS

The punctured holes in the prosthetic graft were successfully sealed with TetraStat in 1 min. The success rate of hemostasis with TetraStat for the punctured holes in the rat vena cava was dose-dependent. TetraStat was effective in sealing the holes created with a 20 G needle at all concentrations; however, the holes created with an 18 G needle could be sealed only when the concentration ≥60 g/L. Hemostasis using SURGICEL or TachoSil was less successful and sometimes required up to 5 min.

CONCLUSIONS

TetraStat has a high hemostatic ability. A porous PEG sponge soaked with TetraStat is a useful choice for effective hemostasis during massive hemorrhage.

摘要

背景

TetraStat是一种四臂聚乙二醇（PEG）水凝胶。它是一种合成密封剂，可响应pH变化立即固化。本研究旨在通过评估未来临床应用的实验来评估TetraStat的止血效果。

方法

我们使用TetraStat、氧化再生纤维素（SURGICEL®）以及纤维蛋白原和凝血酶密封贴片（TachoSil®）进行体外和体内实验。体外实验使用在高压下充满磷酸盐缓冲盐水的封闭循环系统。制造针刺孔并使用各种密封剂封闭。体内实验中，用18号和20号（G）针头穿刺大鼠腔静脉，让出血持续数秒。将浸泡有TetraStat的多孔PEG海绵用作止血系统。比较了不同浓度（40 - 100 g/L）的TetraStat、SURGICEL和TachoSil之间的止血效果。

结果

TetraStat在1分钟内成功密封了人工血管移植物中的穿刺孔。TetraStat对大鼠腔静脉穿刺孔的止血成功率呈剂量依赖性。TetraStat在所有浓度下对用20G针头制造的孔都能有效密封；然而，只有当浓度≥60 g/L时，用18G针头制造的孔才能被密封。使用SURGICEL或TachoSil止血的成功率较低，有时需要长达5分钟。