The Emergence of New Blood Coagulation Materials Can Reduce the Mortality of Trauma Patients by 30%
Traumatic blood loss is the main killer of patients in the emergency room. Uncontrollable bleeding can cause the patient to die from excessive blood loss within a few minutes. It is relatively easy to treat in a hospital environment. The problem is that it can happen suddenly, and first responders do not have the tools like the emergency room. Therefore, timely and effective control of bleeding is a major challenge facing trauma centers around the world. For bleeding on the surface of the limb, the bleeding can be stopped in time by physical pressing and the use of hemostatic gauze. But for the hemostasis of internal bleeding, even in hospitals, surgery or the injection of platelets or whole blood are still required to control bleeding, but these blood products require extremely high storage conditions and cannot be carried by emergency personnel. Currently, there is no effective hemostasis method to control internal bleeding at the scene of the incident, which causes more than 30% of trauma patients to die from treatable bleeding. Now, scientists at Harvard University have developed a new blood coagulation material, which is portable and easy to store, and may help people survive long enough to reach the hospital.
Harvard Developed a New Coagulant: Portable and with Longer Storage Time
In the human body, platelets are specialized cells that circulate in the blood and are always alert for damage that may cause bleeding. When they find a wound, they activate and rush to the injured area to cause a blood clot. This is an important biological process that prevents us from bleeding to death from every small wound and abrasion.
But the effectiveness of natural processes for more serious injuries is limited. In a hospital setting, doctors can use blood clotting agents, including donated platelets, to help this process. Unfortunately, this kind of medical supplies need to be refrigerated, and even this cannot last for a long time, so people cannot be carried to the scene where they are most needed.
"Our goal is to provide emergency personnel with a tool to stop internal bleeding. This tool can be easily put in a backpack or stored in an ambulance. Once the bleeding patient is injected intravenously, it can be used for a long time. Stop the internal bleeding and send the patient to the hospital," said Samir Mitragotri, senior author of the study.
The Harvard team’s solution is a coagulant that can be injected into the blood. It can be freeze-dried to give it a marshmallow-like consistency and can be stored at room temperature for several months at a time. When needed, it can be combined with normal saline and can be injected at any time.
The researchers call their creation HAPPI, short for Hemostatic Agents via Polymer Peptide Interfusion. It binds to activated platelets in the injured area and helps more platelets to aggregate there. Since it only binds to activated platelets, not those that roam in the blood, HAPPI can be injected anywhere in the body and will only help clotting at the wound.
But the effectiveness of natural processes for more serious injuries is limited. In a hospital setting, doctors can use blood clotting agents, including donated platelets, to help this process. Unfortunately, this kind of medical supplies need to be refrigerated, and even this cannot last for a long time, so people cannot be carried to the scene where they are most needed.
"Our goal is to provide emergency personnel with a tool to stop internal bleeding. This tool can be easily put in a backpack or stored in an ambulance. Once the bleeding patient is injected intravenously, it can be used for a long time. Stop the internal bleeding and send the patient to the hospital," said Samir Mitragotri, senior author of the study.
The Harvard team’s solution is a coagulant that can be injected into the blood. It can be freeze-dried to give it a marshmallow-like consistency and can be stored at room temperature for several months at a time. When needed, it can be combined with normal saline and can be injected at any time.
The researchers call their creation HAPPI, short for Hemostatic Agents via Polymer Peptide Interfusion. It binds to activated platelets in the injured area and helps more platelets to aggregate there. Since it only binds to activated platelets, not those that roam in the blood, HAPPI can be injected anywhere in the body and will only help clotting at the wound.
New Coagulant Has Outstanding Coagulation Effect
In tests on mice, the team found that HAPPI can reduce bleeding time by 99% and blood loss by 97%. For trauma, this material can increase the median survival rate to more than 1 hour, which is enough for medical staff to send injured patients to the hospital for further treatment.
"Many trauma-related deaths occurred within the first hour, when there was a lot of blood loss, and there was no intervention," said Gao Yongsheng, a postdoctoral research assistant at SEAS and co-first author of the paper. "For first responders, a key goal is to keep the trauma patients alive during this so-called golden time, and to send them to the hospital during this time, because once they get to the hospital, it’s completely another State now."
The team stated that the next steps are to expand the scale of production of materials used to make HAPPI and test them on larger animals.
Other similar blood clotting agents are also under study, including a blood clotting agent made from snake venom that can be injected into the wound site, and one that binds to fibrin to strengthen thrombus in a way similar to that of HAPPI and platelets.
"Many trauma-related deaths occurred within the first hour, when there was a lot of blood loss, and there was no intervention," said Gao Yongsheng, a postdoctoral research assistant at SEAS and co-first author of the paper. "For first responders, a key goal is to keep the trauma patients alive during this so-called golden time, and to send them to the hospital during this time, because once they get to the hospital, it’s completely another State now."
The team stated that the next steps are to expand the scale of production of materials used to make HAPPI and test them on larger animals.
Other similar blood clotting agents are also under study, including a blood clotting agent made from snake venom that can be injected into the wound site, and one that binds to fibrin to strengthen thrombus in a way similar to that of HAPPI and platelets.
