Non-oxidized cellulose nanofibers as a topical hemostat: In vitro thromboelastometry studies of structure vs function. (1st August 2021)

• Record Type: Journal Article
• Authors: Mohamed, Elmira; Coupland, Lucy A.; Crispin, Philip J.; Fitzgerald, Ailene; Nisbet, David R.; Tsuzuki, Takuya
• Is Part Of: Carbohydrate polymers. Volume 265(2021)
• Publication Date: 2021-08-01
• Subjects: Non-oxidized cellulose nanofibers -- Ball-milling -- Green hemostatic material -- Blood-material interaction -- In vitro thromboelastometry; Polysaccharides -- Periodicals; Polysaccharides -- Periodicals; Polysaccharides -- Périodiques; Electronic journals; 547.78
• DOI: 10.1016/j.carbpol.2021.118043
• Languages: English
• ISSNs: 0144-8617

Abstract

Graphical abstract: Non-oxidized cellulose nanofibers (CNFs) were produced using ball-milling of cellulose. The optimized nanofibers with high aspect ratio and specific surface area induced robust clotting in thromboelastomtry by increasing fibrin formation and trapping of platelets. Highlights: Non-oxidized cellulose nanofibers made by ball-milling induce effective clotting. The promotion of hemostasis is dependent on the size and morphology of nanofibers. Nanofibers with a higher specific surface area enhance plasma coagulation. Nanofibers with a higher aspect ratio entrap and activate platelets. Abstract: Hemorrhage remains a significant cause of morbidity and mortality following trauma and during complex surgeries. A variety of nanomaterials, including oxidized cellulose nanofibers (OCNFs), have been studied to overcome the disadvantages of current commercial topical hemostats. However, the relationship between nano-structural characteristics and hemostatic efficacy of non-oxidized cellulose nanofibers (CNFs) has not been elucidated. Herein, we present the first report of the correlation between structure and hemostatic performance of CNFs. In vitro thromboelastometry studies on CNFs, synthesized by ball-milling, showed that there is an optimum balance point between the aspect ratio (AR) and specific surface area (SSA) of nanofibers in terms of their maximum contribution to platelet function and plasma coagulation. The optimized CNFs with high SSA (17 m 2 /g) and a high AR (166) shortened normal whole blood clotting time by 68 %, outperforming cellulose-based hemostats. Additionally, CNFs reduced clotting time in platelet-deficient blood (by 80 %) and heparinized blood (by 54 %).