A Review of Hemostatic Agents and Products

Severe hemorrhage is the leading cause of death in comilitary and civilian trauma. Approximately half of road crash fatalities occur due to severe hemorrhage before hospital arrival. In severe cases of bleeding, the use of agents that accelerate blood coagulation (hemostatic agents) is required. The aim of this study was to review on the hemostatic agents and products, from research to commercial stages, and categorizing them based on the physiology of hemostasis. Moreover, the applications and adverse effects of each category have been reviewed and compared; it can be an important step towards optimal clinical application of products and novel original reasearch design continuing the previous studies.

Literature search was conducted in scientific databases of PubMed, Scopus, Science Direct, SID, Magiran and IranMedex without filtering release date, by combining related keywords including hemostatic agents, bleeding, dressings and trauma. The abstracts were screened by two reaserchers independently to select the appropriate studies.

In this study, according to the basics of blood coagulation, the hemostatic agents and products were classified into five groups based on the mechanism of action including: (1) coagulants and procoagulants, (2) the concentrators of coagvlant factors, (3) mechanical cougulaton substrates, (4) physiologic coagulants and (5) chemical coagulants. The mechanism of action, applications, and side effects have been compared in each category.

Each hemostatic product can be more effective in special situations, in military and civilian trauma, due to their potency and mechanisms of action.