Metal oxide surface charge mediated hemostasis.

Blood coagulates faster upon contact with polar glasslike surfaces than on nonpolar plastic surfaces; this phenomenon is commonly termed the glass effect. However, the variable hemostatic response that we report here for contact-activated coagulation by different metal oxides, all of which are polar substrates, requires a refinement of this simple polarity model of how inorganic metal oxides activate the intrinsic pathway of blood coagulation. To our knowledge, the role of metal oxide surface charge as determined at the physiological pH and Ca2+ concentration of blood has not been previously investigated. We find that basic oxides with an isoelectric point above the pH of blood are anticoagulant while acidic oxides with an isoelectric point below the pH of blood are procoagulant. Using a thromboelastograph, we find that the onset time for coagulation and rate of coagulation post-initiation depend on both the sign and the magnitude of the initial surface charge density of the metal oxide. This work presents a useful strategy based on a quantifiable material parameter to select metal oxides to elicit a predictable and tunable biological response when they are in contact with blood.

Testing of modified zeolite hemostatic dressings in a large animal model of lethal groin injury.

BACKGROUND: We have previously identified a granular zeolite hemostat (ZH) as an effective agent for control of severe bleeding, and it is currently being used by the US troops in the battlefield. ZH causes an exothermic reaction on application, which theoretically can be decreased by altering its chemical composition or changing its physical properties. However, the effect of these alterations on the hemostatic efficacy is unknown. We tested modified zeolites and a chitosan based dressing against controls in a swine model of battlefield injury. METHODS: A complex groin injury was created in 60 swine (40-55 kg). This included semi-transection of the proximal thigh (level of inguinal ligament), and complete division of the femoral artery and vein. After 3 minutes, the animals were assigned to (1) no dressing (ND), (2) standard dressing (SD), (3-5) SD + chemically modified ZHs, where calcium was substituted with sodium (Na), barium (Ba), or silver (Ag), respectively, (6) SD + physically modified ZH, where "beads" were packaged in a fabric bag, (7) SD + chitosan based dressing (CD). Resuscitation was started 15 minutes after application of dressing (500 mL of 6% hetastarch over 30 minutes). Survival for 180 minutes was the primary endpoint for this study. In addition, blood loss, wound temperatures, and histologic tissue damage were recorded. RESULTS: Mortality in the group that was treated with the application of bagged ZH was 10% versus 100% in the no dressing group and 50% in the SD group (p < 0.05 vs. ND and SD groups). The Na ZH group had a mortality rate of 43%, whereas application of Ba and Ag substituted zeolites, and CD were associated with a mortality rate of 25%. Ionic substitution of zeolite decreased the in vivo temperature peak by 5 to 10 degrees C. No histologic evidence of tissue necrosis was noted in this experiment. CONCLUSIONS: The use of zeolite hemostat can control hemorrhage and dramatically reduce mortality from a lethal groin wound. Modifications of zeolite hemostat can decrease the exothermic reaction and attenuate tissue damage.

Oxide hemostatic activity.

The tunable in vitro blood clotting activity of high-surface-area hemostatic bioactive glass is evaluated by Thromboelastograph, a clinical instrument for quantifying changes in blood during coagulation. The hemostatic trends associated with hemostatic bioactive glass and a new preparation of spherical hemostatic bioactive glass, along with similar Si- and Ca-containing oxides, are described and related to Si:Ca ratios, Ca2+ availability and coordination environment, porosity, DeltaHHydration, and surface area. Hemostatic bioactive glass is a new material with an excellent efficacy for inducing hemostasis and is chemically distinct from the traditional bioglass employed for bone growth.

Host-guest composites for induced hemostasis and therapeutic healing in traumatic injuries.

INTRODUCTION: The United States military currently outfits our soldiers with a zeolite-based hemostatic agent (HA) that is applied directly onto a traumatic wound to induce hemostasis and prevent loss of life from exsanguination. The goals of this work were to identify and implement strategies to attenuate a tissue burning side effect associated with the HA, resulting from a large release of heat upon hydration, without adversely affecting the wound healing properties. Five ion exchanged derivatives of the parent HA were prepared and characterized with regard to their material and thermal properties, in vitro hemostatic efficacy, and antibacterial activity. METHODS: The five host-guest high-surface-area HAs were prepared by ion exchanging the zeolite linde type 5A with aqueous salt solutions under controlled conditions. The modified HAs were characterized by TGA, DSC, Thermal Imaging, SEM, XRD, XPS, BET, and a Thromboelastograph (TEG) was employed to assay the in vitro hemostatic efficacy. Antibacterial activity was assayed by measuring the zone of no growth of Pseudomonas aeruginosa biofilms growing in contact with the ion exchanged HAs. RESULTS: The heat released during application of the HA can be minimized from 680 J/g to 420 J/g by ion exchanging the calcium ions in zeolite linde type 5A with cations of a reduced hydration enthalpy. Zeolite-based HAs that demonstrate in vitro clot induction time of R < or = 1.8 min, and with surfaces areas > or = 634 m2/g, correlate with 75% in vivo swine survivability of a universally lethal groin injury. Silver exchanged HA maintained a zone of no growth of P. aeruginosa with a surface area twice the geometrical surface area of an HA pressed pellet for 24 hours in an LB Agar assay. CONCLUSIONS: Two strategies for reducing the large amount of heat released by a zeolite-based HA during application have been described and quantified: (1) ion exchange and (2) prehydration. Five ion-exchanged derivatives of the original HA have been prepared and assayed for hemostatic efficacy both in vitro, by TEG, and in vivo, by clinical swine trials. Contact activation coagulation rates, alpha, were found to increase with the amount of heat released by the HA. In Vitro clot induction time, R, and HA surface area have been identified as predictors of in vivo hemostatic performance. A proposed rationale for selecting hemostatic materials based on these parameters will likely reduce the quantity of experiments involving animals, and the associated labor and capital costs, necessary to test a new HA. A method for incorporating antibacterial activity against gram negative P. aeruginosa into the Ag-exchanged formulation of zeolite LTA-5A has been described and substantiated.

Free-standing mesoporous titania films with anatase nanocrystallites synthesized at 80 degrees C.

Free-standing 10 microm thick mesoporous titania films containing anatase nanocrystallites have been prepared and their structural evolution as a function of calcination temperature is reported.