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Experimental Aspects of Topical Haemostatic Agents

Björses, Katarina LU (2010) In Lund University, Faculty of Medicine Doctoral Dissertation Serie 2010:127.
Abstract
Control of haemorrhage is vital in all operative settings. As complement to traditional surgical haemostatic techniques, a heterogeneous collection of absorbable substances with haemostatic capacity have been developed; topical haemostatic agents. The widespread variety of the products and the study-populations (clinical or experimental) make interpretation of previously performed studies difficult.



The general aim of this thesis was to evaluate the haemostatic efficacy of four principally different basic substances in two separate experimental bleeding models.



Two coagulation factors; bovine thrombin (bT) and recombinant FVIIa (rFVIIa) and two passive substances; gelatine and microporous... (More)
Control of haemorrhage is vital in all operative settings. As complement to traditional surgical haemostatic techniques, a heterogeneous collection of absorbable substances with haemostatic capacity have been developed; topical haemostatic agents. The widespread variety of the products and the study-populations (clinical or experimental) make interpretation of previously performed studies difficult.



The general aim of this thesis was to evaluate the haemostatic efficacy of four principally different basic substances in two separate experimental bleeding models.



Two coagulation factors; bovine thrombin (bT) and recombinant FVIIa (rFVIIa) and two passive substances; gelatine and microporous polysaccharide hemospheres (MPH) were evaluated, separately and combined, in a randomized fashion.



Heparinized rats were used in all studies. In Paper I a new arterial high flow bleeding model was used and in Paper II-IV a renal bleeding model. The animals were additionally platelet inhibited in Paper III.



Neither pure coagulation factors nor MPH was better than gauze (negative control).

Gelatine was effective in heparinized rats, when platelet inhibition was added complementary bT was required for rapid and durable haemostasis. Topical rFVIIa proved a weak haemostatic effect compared to the effect when administered IV (positive control).



Degradable starch microspheres (DSM) are similar to MPH. In Paper IV chemical modifications of DSM were performed, evaluated in vitro (thrombin generation and platelet adhesion tests), and in vivo. DSM modified to activate platelets demonstrated best haemostatic effect.



In conclusion; for sufficient haemostatic effect, a topical agent is required to: adhere rapidly to the bleeding source, activate platelets and also stimulate the coagulation. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Prof Bergqvist, David, Uppsala Universitet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
platelet stimulation, coagulation factors, experimental bleeding models, topical haemostatic agents
in
Lund University, Faculty of Medicine Doctoral Dissertation Serie
volume
2010:127
pages
150 pages
publisher
Lund University
defense location
Universitetsklinikens aula, ing 35, SUS Malmö
defense date
2010-12-11 10:00
ISSN
1652-8220
ISBN
978-91-86671-43-3
language
English
LU publication?
yes
id
844a882a-f35d-426c-bf38-99d4f3ad7de1 (old id 1718716)
date added to LUP
2010-11-22 13:59:35
date last changed
2018-05-29 10:40:04
@phdthesis{844a882a-f35d-426c-bf38-99d4f3ad7de1,
  abstract     = {Control of haemorrhage is vital in all operative settings. As complement to traditional surgical haemostatic techniques, a heterogeneous collection of absorbable substances with haemostatic capacity have been developed; topical haemostatic agents. The widespread variety of the products and the study-populations (clinical or experimental) make interpretation of previously performed studies difficult.<br/><br>
<br/><br>
The general aim of this thesis was to evaluate the haemostatic efficacy of four principally different basic substances in two separate experimental bleeding models.<br/><br>
<br/><br>
Two coagulation factors; bovine thrombin (bT) and recombinant FVIIa (rFVIIa) and two passive substances; gelatine and microporous polysaccharide hemospheres (MPH) were evaluated, separately and combined, in a randomized fashion.<br/><br>
<br/><br>
Heparinized rats were used in all studies. In Paper I a new arterial high flow bleeding model was used and in Paper II-IV a renal bleeding model. The animals were additionally platelet inhibited in Paper III.<br/><br>
<br/><br>
Neither pure coagulation factors nor MPH was better than gauze (negative control). <br/><br>
Gelatine was effective in heparinized rats, when platelet inhibition was added complementary bT was required for rapid and durable haemostasis. Topical rFVIIa proved a weak haemostatic effect compared to the effect when administered IV (positive control).<br/><br>
<br/><br>
Degradable starch microspheres (DSM) are similar to MPH. In Paper IV chemical modifications of DSM were performed, evaluated in vitro (thrombin generation and platelet adhesion tests), and in vivo. DSM modified to activate platelets demonstrated best haemostatic effect.<br/><br>
<br/><br>
In conclusion; for sufficient haemostatic effect, a topical agent is required to: adhere rapidly to the bleeding source, activate platelets and also stimulate the coagulation.},
  author       = {Björses, Katarina},
  isbn         = {978-91-86671-43-3},
  issn         = {1652-8220},
  keyword      = {platelet stimulation,coagulation factors,experimental bleeding models,topical haemostatic agents},
  language     = {eng},
  pages        = {150},
  publisher    = {Lund University},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Serie},
  title        = {Experimental Aspects of Topical Haemostatic Agents},
  volume       = {2010:127},
  year         = {2010},
}