Low‐Fouling Zwitterionic Polymeric Colloids as Resuscitation Fluids for Hemorrhagic Shock. Issue 47 (17th October 2022)

• Record Type: Journal Article
• Authors: Kumar, Rajesh; Mancebo, Julia Garcia; Patenaude, Ryan; Sack, Kristen; Prondzynski, Maksymilian; Packard, Alan B.; Dearling, Jason L. J.; Li, Ruihan; Balcarcel‐Monzon, Michelle; Dominguez, Saffron; Emani, Sirisha; Kheir, John N.; Polizzotti, Brian; Peng, Yifeng
• Is Part Of: Advanced materials. Volume 34:Issue 47(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-10-17
• Subjects: biocompatibility -- biomaterials -- hemorrhagic shock -- resuscitation -- zwitterionic polymers; Materials -- Periodicals; Chemical vapor deposition -- Periodicals; 620.11
• DOI: 10.1002/adma.202207376
• Languages: English
• ISSNs: 0935-9648

Abstract

Abstract: Colloids, known as volume expanders, have been used as resuscitation fluids for hypovolemic shock for decades, as they increase plasma oncotic pressure and expand intravascular volume. However, recent studies show that commonly used synthetic colloids have adverse interactions with human biological systems. In this work, a low‐fouling amine(N)‐oxide‐based zwitterionic polymer as an alternative volume expander with improved biocompatibility and efficacy is designed. It is demonstrated that the polymer possesses antifouling ability, resisting cell interaction and deposition in major organs, and is rapidly cleared via renal filtration and hepatic circulation, reducing the risk of long‐term side effects. Furthermore, in vitro and in vivo studies show an absence of adverse effects on hemostasis or any acute safety risks. Finally, it is shown that, in a head‐to‐head comparison with existing colloids and plasma, the zwitterionic polymer serves as a more potent oncotic agent for restoring intravascular volume in a hemorrhagic shock model. The design of N‐oxide‐based zwitterionic polymers may lead to the development of alternative fluid therapies to treat hypovolemic shock and to improve fluid management in general. Abstract : A low‐fouling N‐oxide‐based zwitterionic polymer is developed as a colloid for fluid resuscitation, which simultaneously improves oncotic potency and biocompatibility to resist interference with coagulation or deposition in major organs. When used as fluid therapy in a severe hemorrhagic shock model, it significantly improves resuscitation outcomes when compared with existing colloids or plasma (the gold standard).