Adhesive Hemostatic Hydrogel with Ultrafast Gelation Arrests Acute Upper Gastrointestinal Hemorrhage in Pigs. (31st December 2021)

• Record Type: Journal Article
• Authors: Xia, Xianfeng; Xu, Xiayi; Wang, Bin; Zhou, Di; Zhang, Weili; Xie, Xian; Lai, Huasheng; Xue, Ju; Rai, Aliza; Li, Zhuo; Peng, Xin; Zhao, Pengchao; Bian, Liming; Chiu, Philip Wai‐Yan
• Is Part Of: Advanced functional materials. Volume 32:Number 16(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: adhesive hydrogels -- endoscopy -- hemostasis -- upper gastrointestinal hemorrhage; Materials -- Periodicals; Chemical vapor deposition -- Periodicals; 620.11
• DOI: 10.1002/adfm.202109332
• Languages: English
• ISSNs: 1616-301X

Abstract

Abstract: Upper gastrointestinal (GI) hemorrhage is a common clinical emergency worldwide. Endoscopic hemostasis is the current first line treatment. Nevertheless, for patients with severe active bleeding and challenging anatomy, endoscopic management can be still difficult and usually requires a higher level of surgical expertise. A simple and effective method of endoscopic hemostasis is therefore in acute clinical demand. Herein a hemostatic hybrid hydrogel comprised of hyaluronic acid and polyethylene glycol stabilized by thiourea–catechol coupling and disulfide bonds is reported. The hybrid hydrogels exhibit enhanced mechanical properties, short gelation time, and good blood clotting ability compared with fibrin gels. The in vivo hemostatic efficacy is confirmed in a rat model of arterial bleeding, in which the rapid gelation of hybrid hydrogels after topical application effectively arrests blood loss with no rebleeding occurring during resuscitation when blood pressure approximately recovers to normal. A large animal study further demonstrates the efficacy of hybrid hydrogels to achieve endoscopic hemostasis against upper GI hemorrhage in pigs. Follow‐up observations show that the hybrid hydrogels can remain adherent at the bleeding wound for 48 h, indicating the sustained hemostatic function in vivo. Collectively, this work demonstrates a promising hemostatic hydrogel for endoscopic hemostasis in upper GI hemorrhage. Abstract : A hybrid adhesive hydrogel comprised of hyaluronic acid and polyethylene glycol stabilized by thiourea–catechol coupling and disulfide bond is developed for endoscopic hemostasis of acute upper gastrointestinal hemorrhage. The hydrogels show enhanced mechanical properties, short gelation time, and good blood clotting ability, showing rapid and sustained hemostatic effects for 48 h in live pigs.