title: Synthetic Strategies for Engineering Intravenous Hemostats.
abstract: While there are currently many well-established topical hemostatic agents for field administration, there are still limited tools to staunch bleeding at less accessible injury sites. Current clinical methods to restore hemostasis after large volume blood loss include platelet and clotting factor transfusion, which have respective drawbacks of short shelf life and risk of viral transmission. Therefore, synthetic hemostatic agents that can be delivered intravenously and encourage stable clot formation after localizing to sites of vascular injury are particularly appealing. In the past three decades, platelet substitutes have been prepared using drug delivery vehicles such as liposomes and PLGA nanoparticles that have been modified to mimic platelet properties. Additionally, structural considerations such as particle size, shape, and flexibility have been addressed in a number of reports. Since platelets are the first responders after vascular injury, platelet substitutes represent an important class of intravenous hemostats under development. More recently, materials affecting fibrin formation have been introduced to induce faster or more stable blood clot formation through fibrin cross-linking. Fibrin represents a major structural component in the final blood clot, and a fibrin-based hemostatic mechanism acting downstream of initial platelet plug formation may be a safer alternative to platelets to avoid undesired thrombotic activity. This Review explores intravenous hemostats under development and strategies to optimize their clotting activity.
authors: †Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States.
authors: Leslie W
authors: LW
authors: Chan
authors: ‡Department of Medicine, Division of Emergency Medicine, University of Washington, Seattle, Washington 98195, United States.
authors: Nathan J
authors: NJ
authors: White
authors: †Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, 3720 15th Avenue NE, Box 355061, Seattle, Washington 98195, United States.
authors: Suzie H
authors: SH
authors: Pun
mesh_terms: D061605:Administration, Intravenous; D000595:Amino Acid Sequence; D000818:Animals; D058045:Artificial Cells / Q000166:cytology; D001792:Blood Platelets / Q000166:cytology / Q000187:drug effects; D055808:Drug Discovery / Q000379:methods*; D005337:Fibrin / Q000378:metabolism; D006487:Hemostasis / Q000187:drug effects*; D006490:Hemostatics / Q000008:administration & dosage / Q000737:chemistry* / Q000494:pharmacology*; D006801:Humans; D008969:Molecular Sequence Data; D010455:Peptides / Q000008:administration & dosage / Q000737:chemistry / Q000494:pharmacology
chemical_list: D006490:Hemostatics; D010455:Peptides; D005337:Fibrin