Department of Nephrology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610207, China.
Adv Sci (Weinh). 2023 Feb;10(5):e2205989. doi: 10.1002/advs.202205989. Epub 2022 Dec 25.
Uncontrolled hemorrhage is a major cause of potentially preventable death in civilian trauma nowadays. Considerable concern has been given to the development of efficient hemostats with high blood absorption, self-propelled property, and Ca release ability, for irregularly shaped and noncompressible hemorrhage. Herein, Janus self-propelled chitosan-based hydrogel with CaCO (J-CMH@CaCO ) is developed by partial ionic crosslinking of carboxylated chitosan (CCS) and Ca , gravity settlement, and photopolymerization, followed by removing the shell of CCS. The obtained J-CMH@CaCO is further used as a hemostat powered by the internal CaCO and coordinated protonated tranexamic acid (J-CMH@CaCO /T). Bubbles are generated and detached to provide the driving force, accompanied by the release of Ca . The two aspects work in synergy to accelerate clot formation, endowing the J-CMH@CaCO /T with excellent hemostatic efficiency. The J-CMH@CaCO /T presents high blood absorption, favorable blood-clotting ability, desired erythrocyte and platelet aggregation, and acceptable hemocompatibility and cytocompatibility. In rodent and rabbit bleeding models, the J-CMH@CaCO /T exhibits the most effective hemostasis to the best knowledge of the authors, wherein the hemorrhage is rapidly halted within 39 s. It is believed that the J-CMH@CaCO /T with self-propelled property opens up a new avenue to design high-performance hemostats for clinical application.
目前,非控制出血是民用创伤中潜在可预防死亡的主要原因。人们非常关注开发具有高血液吸收能力、自推进特性和 Ca 释放能力的高效止血剂,用于治疗形状不规则和不可压缩的出血。在此,通过部分离子交联羧化壳聚糖(CCS)和 Ca、重力沉降和光聚合,然后去除 CCS 的外壳,开发出具有 CaCO 的 Janus 自推进壳聚糖基水凝胶(J-CMH@CaCO)。所得的 J-CMH@CaCO 进一步用作由内部 CaCO 和配位质子化氨甲环酸(J-CMH@CaCO/T)驱动的止血剂。气泡的产生和脱离提供了驱动力,同时伴随着 Ca 的释放。这两个方面协同作用,加速血栓形成,使 J-CMH@CaCO/T 具有优异的止血效率。J-CMH@CaCO/T 具有高血液吸收能力、良好的凝血能力、理想的红细胞和血小板聚集能力以及可接受的血液相容性和细胞相容性。在啮齿动物和兔出血模型中,J-CMH@CaCO/T 表现出最有效的止血效果,据作者所知,出血在 39 秒内迅速停止。据信,具有自推进特性的 J-CMH@CaCO/T 为临床应用设计高性能止血剂开辟了新途径。