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QuikClot® is an antihemorrhagic/hemostatic agent produced by Z-Medica.
Background[edit]
QuikClot was originally available in a granular form of zeolite to be poured directly on a wound to stem bleeding. Zeolite absorbs water in blood, concentrating platelets and clotting factors. This product was discontinued in 2009. The second generation of QuikClot is formulated using pre-hydrated zeolite beads contained in a bag for ease of removal and a significant reduction in the heat generated when reacting with blood. The current generation of QuikClot is a kaolin impregnated gauze which accelerates clotting through the contact activation (intrinsic) pathway by activating factor XII.[1]
Zeolite Products[edit]
The first generation product contained the active ingredient zeolite, which promoted blood clotting by absorbing water and concentrating coagulation factors including platelets. This reaction with blood is exothermic could cause tissue injury. The granular product was discontinued in 2009. Newer generation zeolite formulas, which were cleared by the FDA in 2005, come as pre-hydrated beads in pouches, which produce significantly less heat and can be used more safely to control hemorrhage while reducing the risk of burning.
Kaolin Products[edit]
The current generation of QuikClot products consist of kaolin impregnated gauze which was approved by the FDA in 2007. Kaolin is a naturally occurring, inorganic mineral which does not produce an exothermic reaction. QuikClot kaolin-based products accelerate the body’s natural clotting process by activating factor XII.[2] First introduced as QuikClot Combat Gauze® in 2008, there are now a variety of products available for military, law enforcement, EMS, hospital, and public access use. Over-the-counter(OTC) and consumer versions of the product are also available.
Product History[edit]
Using zeolite as a clotting agent was discovered by Frank Hursey (Z-Medica co-founder) in 1984.[3] Following the creation of QuikClot in 2002, the US armed forces conducted a series of tests comparing different antihemorrhagic technologies, in which zeolite-based QuikClot was chosen as the most effective.[4][5] Following these tests, the US armed forces approved its use in Afghanistan and Iraq.
Following the development of kaolin-based QuikClot products, in 2008, Combat Gauze was recommended as the only hemostatic dressing in the U.S. Military. This was based on extensive testing conducted by the United States Army Institute for Surgical Research (USAISR) and the Naval Medical Research Center (NMRC). After extensive review of current data by the CoTCCC(Committee on Tactical Combat Casualty Care) in 2014, Combat Gauze was re-affirmed as the hemostatic dressing of choice.[6]. In 2013, QuikClot Hemostatic Dressing was cleared for surgical wound/traumatic bleeding by the FDA, and QuikClot Interventional was cleared for use on drug-induced, anticoagulated patients.
Clotting Mechanism[edit]
Kaolin is a naturally occurring, inorganic mineral with no known allergic reactions[7][8], and does not generate heat when in contact with blood. QuikClot kaolin-based products work by activating factor XII, a protein factor in the blood which can initiate the intrinsic pathway of the coagulation cascade. The activation of factor XII by kaolin causes a protein chain reaction which promotes clotting within minutes[9].
References[edit]
- ^ Lamb KM, Pitcher HT, Cavarocchi NC, Hirose H. Vascular site hemostasis in percutaneous extracorporeal membrane oxygenation therapy. Open Cardiovasc Thorac Surg J. 2012;5:8-10.
- ^ Lamb KM, Pitcher HT, Cavarocchi NC, Hirose H. Vascular site hemostasis in percutaneous extracorporeal membrane oxygenation therapy. Open Cardiovasc Thorac Surg J. 2012;5:8-10.
- ^ U.S. patent number 4,822,349, 1989
- ^ "Application of a Zeolite Hemostatic Agent Achieves 100% Survival in a Lethal Model of Complex Groin Injury in Swine," – J Trauma. 2004;56:974–983, Hasan B. Alam, MD
- ^ "Comparative Analysis of Hemostatic Agents in a Swine Model of Lethal Groin Injury" – J Trauma. 2003;54:1007–1082, Hasan B. Alam, MD
- ^ Tactical Combat Casualty Care Guidelines 2 June 2014. http://www.usaisr.amedd.army.mil/pdfs/TCCC_Guidelines_140602.pdf. Accessed March 25, 2015.
- ^ Trabattoni D, Montorsi P, Fabbiocchi F, Lualdi A, Gatto P, Bartorelli A. A new kaolin-based haemostatic bandage compared with manual compression for bleeding control after percutaneous coronary procedures. Eur Radiol. 2011;21:1687-1691.
- ^ Lamb KM, Pitcher HT, Cavarocchi NC, Hirose H. Vascular site hemostasis in percutaneous extracorporeal membrane oxygenation therapy. Open Cardiovasc Thorac Surg J. 2012;5:8-10.
- ^ Pahari M, Moliver R, Lo D, Pinkerton D, Basadonna G. QuikClot® Interventional™ Hemostatic Bandage (QCI): a novel hemostatic agent for vascular access. Cath Lab Digest. 2010;18(1):28-30. http://www.cathlabdigest.com/articles/QuikClot®-Interventional™-Hemostatic-Bandage-QCI-A-Novel-Hemostatic-Agent-Vascular-Access. Accessed on August 10, 2014.
Category:Antihemorrhagics Category:Military equipment of the United States