Overview of Agents Used for Emergency Haemostasis 

 

Published on MedED:  8 October 2020
Type of article: Clinical Article Summary

Compiler: Linda Ravenhill
Sources: Khoshmohabat, H., Paydar, S., Kazemi, H.M., Dalfard,B. Trauma Mon. 2016 February; 21(1): e26023. doi: 10.5812/traumamon.26023 
 
Haemorrhagic shock remains the second most prevalent cause of mortality in civilian trauma. Coagulopathy, hypothermia, infection and multiple organ failure are potential compli¬cations resulting from severe blood loss. Among these, coagulopathy is recognized as the main adverse consequence of severe haemorrhage in trauma patients, with 25% of severely injured trauma patients exhibiting an es¬tablished coagulopathy when they arrive at the emergency department, a phenomenon associated with an increased rate of early and late mortality.
Haemostatic agents can play a key role in establishing haemostasis in prehospital situations and preventing haemorrhage-associated death. 

These agents can be classified by their mechanism of action and include:
1) Factor concentrators: This class of haemostatic agents work through fast absorption of the water content of blood; consequently, concentration of its cellular and protein components results in clot formation.
2) Mucoadhesive agents: these agents act through a strong adherence to the tissues, and physically block bleeding from wounds.
3) Procoagulant supplementors: agents placed in this group act mainly through delivering procoagulant factors to the haemorrhagic wound. 
 
Problems related to the use of haemorrhagic agents include reports of thermal injury and burns resulting from the exothermic reaction and the poor biodegradability; the risk of the transmission of infectious agents and agents com¬posed of granules leaving residue in the lumen of the vessel. In addition, haemostats that activate the clotting pathway can cause endothelial injury and intraluminal dissemination of the clot, resulting in distal thrombosis.
 
Significant improvements however have been made inefficacy of these agents and the reduction of adverse consequences resulting from their use. While the perfect haemostat has not been discovered, haemostatic dressings and agents remain one of the main advancements achieved in recent decades. 

Summary reproduced with kind permission from MedSpec Publishing.
   

Contributor: Linda Ravenhill
Linda Ravenhill is a medical professional with an MA in Journalism. She has worked in the medical, technology and digital development spaces for over 25 years, & has a particular interest in the impact of technology on the delivery of healthcare in the Sub-Saharan Africa region.

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