Abstract
The capacity of a cold atmospheric-pressure air plasma (CAAP) device for advanced first aid is presented. Using swine as an animal model, two trials: 1) a large, curved cut in hindquarters area and 2) amputation of a front leg, were performed. Cold atmospheric-pressure air plasma effluent, which carries reactive oxygen species (ROS) atomic oxygen (OI), is applied for wound treatments. Swift hemostasis of the wounds by the CAAP treatment was demonstrated. The pressure applied by a finger on the cut arteries in trial 1 and the tourniquet applied in trial 2 could be removed immediately after the treatment and there was no re-bleed in both cases. CAAP hemostasis mechanism was explored via in-vitro tests. The tests on sodium citrate mixed blood-droplet samples show that 1) the heat delivered by the CAAP has no impact on the observed clot formation, 2) plasma effluent activates platelets to promote coagulation state and cascade, and 3) the degree of clotting increases with the total amount of applied OI by means of the CAAP effluent. It took only 16 s of the CAAP treatment to reach full clotting, which was considerably shortened from the natural clotting time of about 25 minutes. The tests on smeared blood samples show that the reduction of the platelet count and the increase of RBC count are proportional to the amount of applied OI. A plausible CAAP hemostasis mechanism is concluded from the in vitro test results and the animal model trials.
Highlights
Globular complexes (Figure 8(a) and Figure 8(b)) are formed to trap RBC and activated platelets, leading to the decrease of inactivated platelet concentration; the viscosity of blood samples will be affected by atomic oxygen and oxidants that presumably contribute to the denaturation of albumin [41] as well as other proteins found in the blood
The viscosity of blood is affected by oxidants that presumably contribute to the denaturation of albumin and other proteins found in the blood
A glycoprotein called von Willebrand factor, which is found in blood plasma, further strengthens this adhesion by binding collagen to the platelets; this binding activates platelet integrins, which mediate tight binding of platelets to the extracellular matrix and adhere this platelet plug to the site of injury; this “primary hemostasis” process is accelerated significantly by the OI flux delivered by the cold atmospheric air plasma (CAAP)
Summary
The reactive species carried by the plasma effluent can trigger biochemical reactions, for example, atomic oxygen interacts with H2O, similar oxidants to those released in the vascular lumen are generated to speed up blood clotting and clot formation, and reactive species furnish biocidal effects for sterilization applications, and promote wound healing [23]-[33]. The present work demonstrates the capacity of a CAAP spray on bleeding control in critical situations, via in-vivo trial, using swine as an animal model, and explores its blood coagulation mechanism via in-vitro tests on blood-droplet samples and on smeared blood samples.
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