Injectable, Shape-Recoverable, and Resorbable Nanofiber Foams for Junctional Hemorrhage Control
Abstract
Focus Area: This project relates to Fiscal Year 2019 Peer Reviewed Medical Research Program Topic Area: Hemorrhage Control. About half of battlefield deaths in modern warfare are secondary to uncontrolled hemorrhage, which typically involves the torso and/or limb zones. It was reported that 19% of the potentially survival battlefield deaths from Iraq and Afghanistan 2001 to 2011 involved junctional hemorrhage injuries, with the groin being the most common type of junctional hemorrhage in recent combat. The duration for current therapies for junctional hemorrhage is limited to 4 hours. Unfortunately, in modern warfare the time required for extirpation of a wounded Warfighter from the battlefield with transportation to a hospital can extend to 6 hours or longer. Under these conditions, effective therapies are needed to stabilize patients with junctional hemorrhage long enough to get them to the hospital alive. Implementation of such therapies will improve outcomes from potentially survival traumatic injuries. In this proposal, we will focus on developing a treatment for junctional hemorrhage, consisting of injectable, re-expandable, and resorbable nanofiber-based foams. Overview of the Project: Critical Problem: About 56% and 87% civilian and combat-related mortality caused by traumatic hemorrhage occurs before reaching definitive care. Around 19% of the potentially survivable battlefield deaths from Iraq and Afghanistan 2001 to 2011 involved junctional hemorrhage injuries, with the groin being the most common type of junctional hemorrhage in recent combat. These junctional hemorrhage injuries are difficult to manage, as the vasculature is not amenable to circumferential compression like limb bleeding and tourniquet placement. And there is no effective way to treat such injuries. Any method that rapidly and easily stops junctional hemorrhage and does not mandate reoperation would be an important advance in the treatment of these lethal bleedings. Objective: Our objective is to develop injectable, re-expandable, and resorbable nanofiber-based foams with incorporation of biologically active hemostatic agents for effective management of junctional hemorrhage. Rationale: The proposed studies are based on our recent findings. Our recent studies demonstrated that gas bubbles and gelatin coatings are essential to expand traditional two-dimensional nanofiber membranes into nanofiber foams with controlled thickness and porosity and superelastic properties. Such nanofiber foams exhibit greater capacity of water/blood absorption compared to current commercial products and high efficacy in whole blood clotting assay, in particular for thrombin-incorporated samples. These nanofiber foams are capable of being packed into a syringe for injection. Further in vivo tests indicated the effectiveness of nanofiber foams for hemostasis in a porcine liver injury model. Our recent data demonstrated the shape recovery of expanded nanofiber foams after compression, suggesting that this technology should be useful for management of severe, life-threatening bleeding from junctional wounds in the groin or axilla not amenable to tourniquet application. Herein, we propose to develop injectable, shape-recoverable, and resorbable nanofiber-based foams for junctional hemorrhage control. Ultimate Applicability: The injectable and re-expandable nanofiber-based foams will be used to control junctional hemorrhage not amenable to junctional tourniquet or combined with the use of junctional tourniquet in the pre-hospital setting, permitting a victim to arrive alive at a hospital/forward surgical facility. Historically, most such victims could expire in the field or during the transport prior to reaching a facility. Impact: It is expected that the injectable, shape-recoverable, and resorbable nanofiber-based foams will be efficacious in the management of junctional hemorrhage not amenable to junctional tourniquet. The applicat
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010208
Entities
People
- Mark Carlson
Organizations
- United States Army
- University of Nebraska Medical Center