Comparative Study of Hemostatic Agents Using Thrombelastography

Hemorrhage is one of the leading causes of death in civilian and military trauma. Thrombelastography (TEG) quantitatively measures the viscoelastic changes of whole blood during clotting, from the beginning of coagulation to the end with fibrinolysis. In this study, we successfully developedand used a TEG method to compare a well-known Chinese herb medicine (i.e., Yunnan Baiyao) for hemorrhage control with other commercial hemostatic products (e.g., CeloxTM and QuikClotTM) and chitosan in the form of dry powder or dispersion. When tested in the powder form, the herbal material outperformed CeloxTM as indicated by all three TEG parameters (i.e., reaction time R, clot formation rate α and maximum clot strength MA), and was comparable with QuikClotTM, but showed no exothermic effects. When tested in the dispersion form, which may be easier to use (as a spray) than in the powder form, the herbal material provided better hemostasis than the other materials, where the coagulation actions of the latter were reduced in the dispersion form. In addition, comparison among CeloxTM and various types of chitosan showed the effects of physical and chemical properties of the chitosan-based biomaterials on hemostasis. The hemostatic mechanisms of these agents and their potential benefitsas an inexpensive, safe, and easily available material for hemorrhage control are discussed.