Affiliation:
1. Bundeswehr Hospital Ulm, Department of Anesthesiology Intensive Care Medicine, Emergency Medicine, and Pain Therapy Ulm Germany
2. Institute for Epidemiology and Medical Biometry Ulm University Ulm Germany
Abstract
AbstractBackgroundThe military has used topical hemostatic agents to successfully treat life‐threatening external bleeding for years. In contrast to the military environment, the general population are increasingly prescribed anticoagulants. There are only few comparative evaluations of topical hemostatic agents with anticoagulated human blood. It is important to understand the impact of these agents on those who take anticoagulants.Study design and MethodsCitrated blood of patients treated with enoxaparin, heparin, and acetylsalicylic acid, apixaban or phenprocoumon was incubated with different hemostatic agents (QuikClot Gauze, Celox Granules, Celox Gauze, Chito SAM 100, WoundClot Trauma Gauze, QuikClot Gauze Moulage Trainer and Kerlix) and rotational thromboelastometry was performed with non‐activated thromboelastometry (NATEM reagent).ResultsAll tested agents improved the onset of coagulation in all anticoagulants, mostly to a significant degree. Most significant improvements were produced by QuikClot Gauze and QuikClot Gauze Moulage Trainer, followed by the tested chitosans (Celox Granules, Celox Gauze, Chito SAM 100). Of the anticoagulant groups, the most significant improvements were seen in enoxaparin. This was followed in order by apixaban, heparin, and acetylsalicylic acid, and phenprocoumon.DiscussionAll the hemostatic agents tested were able to activate the clotting cascade earlier and initiate faster clot formation in anticoagulated blood. A definitive head‐to‐head comparison is not feasible, because of the limitations of an in‐vitro analysis. However, the sometimes‐presented hypothesis that kaolin‐based hemostatic agents are ineffective in anticoagulated blood is inaccurate according to our data. Hemostasis with hemostatic agents appears most challenging with phenprocoumon.
Subject
Hematology,Immunology,Immunology and Allergy
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献