Zeolite-based hemostat QuikClot releases calcium into blood and promotes blood coagulation in vitro
Abstract
Jing LI1, #, Wei CAO2, #, Xiao-xing LV1, Li JIANG1, Yue-jun LI1, Wang-zhou LI1, Shao-zong CHEN1, *, Xue-yong LI1,
1Department of Burns and Plastic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi-an 710038, China; 2Department of Interventional Radiology, Tangdu Hospital, the Fourth Military Medical University, Xi-an 710038, China
Aim: To examine the changes in electrolyte concentrations after addition of zeolite-based hemostat QuikClot in blood and the effects of zeolite on blood coagulation in vitro.
Methods: Fresh blood was taken from healthy adult volunteers and sheep, and the electrolyte concentrations in blood were measured using a blood electrolyte analyzer. Zeolite Saline Solution (ZSS) was prepared by addition of 2 g zeolite to 0.9% NaCl solution (4, 8, or 16 mL). The electrolytes in ZSS were measured using inductively coupled plasma atomic emission spectroscopy. The prothrombin time (PT) and activated partial thromboplastin time (APTT) of blood were measured using the test tube method. The activated clotting time (ACT) and clotting rate (CR) of blood were measured with Sonoclot Coagulation and Platelet Function Analyzer.
Results: Addition of zeolite (50 and 100 mg) in 2 mL human blood significantly increased Ca2+ concentration, while Na+ and K+ concentrations were significantly decreased. Addition of zeolite (50 and 100 mg) in 0.9% NaCl solution (2 mL) caused similar changes in Ca2+ and Na+ concentrations. Si4+ (0.2434 g/L) and Al3+ (0.2575 g/L) were detected in ZSS (2 g/8 mL). Addition of ZSS in sheep blood shortened APTT in a concentration dependent manner, without changing PT. ZSS or aqueous solution of CaCl2 that contained Ca2+ concentration identical to that of ZSS significantly shortened ACT in human blood without significantly changing CR, and the effect of ZSS on ACT was not significantly different from that of CaCl2.
Conclusion: Zeolite releases Ca2+ into blood, thus accelerating the intrinsic pathway of blood coagulation and shortening the clot formation time.
Keywords: hemostatics; QuikClot; zeolites; electrolytes; calcium; blood coagulation; prothrombin time; activated partial thromboplastin time; activated clotting time; clotting rate
We would like to acknowledge the invaluable guidance and support provided by Qi-bing MEI, PhD (Department of Pharmacology, Fourth Military Medical University) and Dr Shu-jun HAN, MD (Department of Anesthesiology, General Hospital of Armed Police Forces). We also gratefully acknowledge the superb technical assistance provided by Ping HUANG (Department of Laboratory Medicine, School of Stomatology, Fourth Military Medical University).
# These authors contributed equally to this work.
* To whom correspondence should be addressed.
E-mail cszong@fmmu.edu.cn (Shao-zong CHEN); yuyong@fmmu.edu.cn (Xue-yong LI)
Received 2012-07-02 Accepted 2012-10-18
Keywords:
1Department of Burns and Plastic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi-an 710038, China; 2Department of Interventional Radiology, Tangdu Hospital, the Fourth Military Medical University, Xi-an 710038, China
Aim: To examine the changes in electrolyte concentrations after addition of zeolite-based hemostat QuikClot in blood and the effects of zeolite on blood coagulation in vitro.
Methods: Fresh blood was taken from healthy adult volunteers and sheep, and the electrolyte concentrations in blood were measured using a blood electrolyte analyzer. Zeolite Saline Solution (ZSS) was prepared by addition of 2 g zeolite to 0.9% NaCl solution (4, 8, or 16 mL). The electrolytes in ZSS were measured using inductively coupled plasma atomic emission spectroscopy. The prothrombin time (PT) and activated partial thromboplastin time (APTT) of blood were measured using the test tube method. The activated clotting time (ACT) and clotting rate (CR) of blood were measured with Sonoclot Coagulation and Platelet Function Analyzer.
Results: Addition of zeolite (50 and 100 mg) in 2 mL human blood significantly increased Ca2+ concentration, while Na+ and K+ concentrations were significantly decreased. Addition of zeolite (50 and 100 mg) in 0.9% NaCl solution (2 mL) caused similar changes in Ca2+ and Na+ concentrations. Si4+ (0.2434 g/L) and Al3+ (0.2575 g/L) were detected in ZSS (2 g/8 mL). Addition of ZSS in sheep blood shortened APTT in a concentration dependent manner, without changing PT. ZSS or aqueous solution of CaCl2 that contained Ca2+ concentration identical to that of ZSS significantly shortened ACT in human blood without significantly changing CR, and the effect of ZSS on ACT was not significantly different from that of CaCl2.
Conclusion: Zeolite releases Ca2+ into blood, thus accelerating the intrinsic pathway of blood coagulation and shortening the clot formation time.
Keywords: hemostatics; QuikClot; zeolites; electrolytes; calcium; blood coagulation; prothrombin time; activated partial thromboplastin time; activated clotting time; clotting rate
We would like to acknowledge the invaluable guidance and support provided by Qi-bing MEI, PhD (Department of Pharmacology, Fourth Military Medical University) and Dr Shu-jun HAN, MD (Department of Anesthesiology, General Hospital of Armed Police Forces). We also gratefully acknowledge the superb technical assistance provided by Ping HUANG (Department of Laboratory Medicine, School of Stomatology, Fourth Military Medical University).
# These authors contributed equally to this work.
* To whom correspondence should be addressed.
E-mail cszong@fmmu.edu.cn (Shao-zong CHEN); yuyong@fmmu.edu.cn (Xue-yong LI)
Received 2012-07-02 Accepted 2012-10-18