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Li, C; Saleh, A; Engels, P
Canadian Journal of Surgery, 12/2021, Volume: 64Journal Article
Background: Hemorrhage is a leading cause of death in trauma. Hemorrhage control includes surgical and endovascular techniques, with use of topical hemostatics playing an increasing role. The defensive slime produced by hagfish (a deep-sea animal) forms within milliseconds and entraps up to 26 000 times its weight in water within a fine mesh-like network. Our project aims to determine if hagfish slime can be applied as a novel innovative hemostatic "clot." Methods: Research ethics approval were obtained and a standardized protocol for extraction was developed. Hagfish were anesthetized and electrical stimulation was used to extract slime exudate. The exudate was placed in a buffer solution and tested with normal saline, seawater, blood and varying concentrations of calcium chloride. Initial "clot" samples were evaluated with direct observation to determine viability. Additional viscosity testing using thromboelastography and rheometry was attempted. Results: Thromboelastography and rheometry testing was unsuccessful because of the speed of reaction and the volume limitations of the testing devices. One hundred milligrams of slime exudate in combination with either normal saline or seawater created a total volume of 100 mL of "clot." An experimental set-up was used to mix the slime exudate, solution and calcium and to suspend the formed "clot" above a beaker on a scale. The weight of the solution returning to the beaker over time was used as a proxy for "clot" formation and deterioration. Increasing the amount of calcium added did not increase the amount of slime formed. Tests conducted with blood demonstrated successful creation of a "clot" that was observed to be cohesive and stable for approximately 30 minutes. The "clot" appeared more viscous than the slime created with normal saline or seawater. Conclusion: Initial results show that slime can be formed with solutions isotonic to human plasma. The durability of the slime "clot" created with blood may be due to the clotting cascade interacting with the slime exudate, but further exploration is needed.
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