Posttraumatic Hemorrhage Research Articles

Comparative analysis of the hemostatic effect of systemic recombinant Factor VIIa and exogenous fibrin monomer in an experimental model of heparinization and posttraumatic blood loss

This article presents the results of a study of the systemic hemostatic action of recombinant Factor VIIa in a rabbit model of heparin-induced coagulopathy and posttraumatic bleeding, compared to the administration of exogenous fibrin monomer. The coagulopathy was induced by a single intravenous injection of unfractionated heparin at a dose of 150 IU/kg 15 minutes before injury. Recombinant Factor VIIa (270 μg/kg) or fibrin monomer (0.25 mg/kg) was used as systemic hemostatic agents. One hour after administrating the agents, a standardized liver injury was inflicted, followed by an assessment of blood loss characteristics. Using rotational thromboelastometry and coagulation tests, animal venous blood was analyzed for coagulation time, alpha angle, clot formation time, maximum clot firmness, clot density at 10 minutes, activated partial thromboplastin time, prothrombin time, thrombin time, and fibrinogen concentration. Pharmacologically induced coagulopathy resulted in shifts to a hypocoagulable profile, associated with severe blood loss (1.9 times, p = 0.028) and high animal mortality (26.1%, p = 0.022) compared to the control group. Preventive administration of fibrin monomer or recombinant Factor VIIa reduced posttraumatic blood loss (by 5.4 times, p 0.001, and by 2.1 times, p = 0.009, respectively), resulting in a decrease in mortality rates. However, the administration of these agents did not correct the hypocoagulable profile as observed in thromboelastometry and coagulation tests. These data demonstrate the hemostatic effect of both agents, with a more pronounced effect after fibrin monomer administration, and suggest potential use of low doses of fibrin monomer in trauma-related hemorrhage. The mechanism of action of fibrin monomer requires further investigation. Therefore, fibrin monomer, a fibrinogen derivative obtained from blood plasma, could be a valuable candidate for managing wound bleeding in addition to recommended systemic hemostatics.

An aligned pattern sponge based on gelatin for rapid hemostasis

Post-traumatic hemorrhage is a leading cause of morbidity and mortality. However, most current hemostatic materials focus on incorporating nutritional components, with limited research addressing the impact of the material's structure on hemostasis. In this study, we developed cytocompatible and hemocompatible three-dimensional gelatin sponges with a patterned and aligned structure, designed for rapid hemostasis. The sponges were characterized by light microscope photography and scanning electron microscopy (SEM). Pattern sponges with gelatin (P-Gelatin) exhibited aligned structures on their surfaces and the inner structure. In terms of biocompatibility, MTT assay, and hemolysis experiment showed that P-Gelatin had good cytocompatibility and hemocompatibility.In vivoblood coagulation andin vivohemostasis, P-Gelatin sponges, with their aligned structure, exhibit rapid adsorption of red blood cells and platelets compared to non-patterned gelatin counterparts. This work introduces a safe and convenient patterned sponge for rapid hemostasis, especially highlighting a concept where a patterned structure can enhance the effectiveness of blood clotting, which is particularly relevant for tissue engineering.

Arachnoidal cyst of the brain with post-traumatic hemorrhage: case report and literature review

Introduction. Arachnoid cysts (AC) occur in 1-3% of children. There is sacs with spinal fluid between brain and arachnoid membrane. Only about 6% of intracranial AC manifest clinically. AC can be complicated by hemorrhage with traumatic brain injury and spontaneously. Materials and methods. We have described a clinical case of AC, complicated by hemorrhage with the subdural hematoma after brain injury and literature review. There is unusually that after drainage of the hematoma, complete resolution of the AK was noted (the only such case described in the literature). Conclusion. The asymptomatic AC can be complicated by hemorrhage due brain injury or spontaneously. Due to the high elastic properties of the brain in children, complete regression of even long-existing AC is possible.

Functional evaluation of joint in moderate to severe hemophilia patients treated with on-demand factor replacement: insights from a single hemophilia treatment center in Bangladesh

BackgroundHemophilia patients are prone to spontaneous or post-traumatic bleeding, particularly in joints and various other body sites. The high incidence of joint hemorrhages in hemophilia patients underscores the importance of routine joint assessments in clinical care to monitor the condition and evaluate the efficacy of hemophilia treatments.AimThis study aimed to assess the joint health of hemophilia patients receiving FVIII or FIX on-demand replacement therapy treatment at a tertiary care hospital in Bangladesh.MethodsThis single-center study involved 93 patients diagnosed with moderate (n = 72;77.4%) and severe (n = 21;22.6%) hemophilia. The assessment of joint health was carried out on six key joints—both elbows, knees, and ankles—using the Hemophilia Joint Health Score (HJHS) version 2.1. Clinical and laboratory data were meticulously documented in a structured questionnaire.ResultsAmong the 93 hemophilic patients, the majority had hemophilia A (96.8%). The median HJHS of the patients was 15 (IQR:9.5–20) with the knee joint being mostly affected (88.2%). A significant positive correlation was observed between HJHS and age (r = 0.385, p < 0.001) and total number of joints involved (r = 0.405, p < 0.001). No significant association was found between factor level, education status, and socio-economic status with HJHS score.ConclusionEarly assessment and monitoring of joint health are essential in clinical practice to prevent severe complications in hemophilia patients.

Clinical, Demographic, And Haematological Profile of Haemophilia Patients at Sir Sunder Lal Hospital Varanasi With CoE Haemoglobinopathies And Day Care Centre

Introduction: Hemophilia is a recessive coagulation and bleeding disorder that is X-linked and inheritable. The Factor VIII (F8) and Factor IX (F9) genes are involved in hemophilia A and B, two hereditary diseases. The process of hemostasis is hampered by spontaneous or post-traumatic bleeding, which also increases the risk of hemophilia. Aim: The purpose of our study is to evaluate the hematological, clinical, and demographic traits of individuals with hemophilia A and B. Results: A total of 646 hemophilia patients were examined during the study period. the majority of hemophilia A patient 544 (84.21%) and hemophilia B102 (16.01%). Based on severity, severe 342 (52.94%), Moderate 247 (38.24%), and Mild (8.82%) had been diagnosed Most common age group was &lt;1 -58 years. The bulk of the study population had a mean age of (Mean ±SD=18.45±13.00) and a median of 17. Maximum number of patients at the ages of 21 and 30 years (21.05%) and a median of 25. The most common age of spontaneous bleeding across all patients was 17 and there was no discernible difference between those with moderate and severe symptoms of bleeding. Hemarthrosis infection (target joint) was most prevalent (79.10%), then prolonged bleeding after cut/ trauma (62.38%). Hemarthrosis knee joint was the joint that was infected (target joint) the most common (79.10%), followed by joint bleeding (46.75%) Severe disease affected the knee joint more frequently than moderate disease. Conclusion: The present research revealed differences in the incidence and nature of bleeding on its own in hemophilia patients. Gum bleeding and posttraumatic bleeding in a child who is otherwise healthy should alert the doctor to consider hemophilia onset is &lt;1 year. On the other hand, 61.3% of patients had hemophilia when they received their initial diagnosis. The median number of bouts of

Assessment of Public Awareness on Alarming Signs of Posttraumatic Intracranial Hemorrhage in the Jeddah Population: A Cross-Sectional Study.

Background Post-traumatic intracranial hemorrhage is a life-threatening condition, and early detection and response can significantly reduce morbidity and mortality rates. The aim of this study was to assess public awareness of the alarming signs of intracranial bleeding after trauma in adults in Jeddah, Saudi Arabia. Methodology From August 2023 to April 2024, a descriptive cross-sectional study was conducted using a five-scale structured questionnaire: demographics, risk factors for road traffic accidents, alarm signs and symptoms, ability to recognize these signs, and participants who experienced head trauma. The study focused on people aged 18 and over living in Jeddah. Results A total of 584 participants were included, with 34.2% males and 65.8% females. Findings revealed that 57% recognized the critical need for medical help after head trauma. Furthermore, only 45% of the population were unaware that low levels of awareness or wakefulness indicate bleeding, reflecting a low awareness level in the adult population. Among children, only 34% recognized changes in eating and lactation habits, and 54% identified continuous crying and irritability. Furthermore, 66% of participants identified loss or change in consciousness as a symptom that required hospital admission, while 60% recognized chronic headaches as a critical sign. Conclusion This study revealed the critical need for public health campaigns to improve awareness and understanding of signs of intracranial post-traumatic bleeding. The results highlighted the importance of early medical interventions to reduce the morbidity and mortality associated with this condition.

Recent Advances in Gene Therapy for Hemophilia: Projecting the Perspectives.

One of the well-known X-linked genetic disorders is hemophilia, which could be hemophilia A as a result of a mutation in the F8 (factor VIII) gene or hemophilia B as a result of a mutation in the F9 (factor IX) gene, leading to insufficient levels of the proteins essential for blood coagulation cascade. In patients with severe hemophilia, factor VIII or factor IX activities in the blood plasma are considerably low, estimated to be less than 1%. This is responsible for spontaneous or post-traumatic bleeding episodes, or both, leading to disease complications and death. Current treatment of hemophilia relies on the prevention of bleeding, which consists of expensive lifelong replacement infusion therapy of blood plasma clotting factors, their recombinant versions, or therapy with recombinant monoclonal antibodies. Recently emerged gene therapy approaches may be a potential game changer that could reshape the therapeutic outcomes of hemophilia A or B using a one-off vector in vivo delivery and aim to achieve long-term endogenous expression of factor VIII or IX. This review examines both traditional approaches to the treatment of hemophilia and modern methods, primarily focusing on gene therapy, to update knowledge in this area. Recent technological advances and gene therapeutics in the pipeline are critically reviewed and summarized. We consider gene therapy to be the most promising method as it may overcome the problems associated with more traditional treatments, such as the need for constant and expensive infusions and the presence of an immune response to the antibody drugs used to treat hemophilia.

Post-traumatic hemorrhage in a large sacral Tarlov cyst causing acute radiculopathy

Symptomatic Tarlov cysts (TCs) are an under-recognized clinical entity that should be considered in the differential for lower back pain. These are more common in women and can also be a cause of pelvic pain. Hemorrhagic TCs have been rarely reported in the literature, with symptoms ranging from lower back pain and radiculopathy to symptoms of cauda equina syndrome. We report on a female patient in her 50s who presented with radicular symptoms as a consequence of TC hemorrhage. Magnetic resonance imaging is the gold standard investigation, and this showed post-traumatic hemorrhage causing irritation of the sciatic nerve. Hemorrhagic TC is an important differential to consider in the setting of acute radicular pain, and the symptoms can be resolved with conservative management.

Granular Hemostatic Composite of Alginate, Calcium, and Zinc for Rapid and Effective Management of Post-Traumatic Hemorrhage.

Post-traumatic hemorrhage, which can result from accidents or battlefield injuries, is a significant global concern due to the high prehospital mortality rate. Substantial efforts have been made to develop hemostatic agents that can effectively reduce hemorrhage in the immediate aftermath of a traumatic event. The present study investigated the potential efficacy of Ca2+ and Zn2+ supplemented sodium alginate-based dry hemostatic particles (SA-CZ DHP) to manage excessive blood loss or post-traumatic hemorrhage. SA-CZ DHP were developed, followed by their physical and biochemical characterization, cytocompatibility and hemocompatibility testing, and critical evaluation of the hemostatic potential in vitro and in vivo. The safe SA-CZ DHP showed high absorption and accelerated blood clotting kinetics with reduced coagulation time (≈70%, p < 0.0001) in whole human blood, observed with insignificant hemolysis and uninterrupted RBC morphology. SA-CZ DHP significantly reduced the mean blood loss (≈90% in SD rats tail incision), and bleeding time (≈60% in BALB/c mice tail incision) was at par with commercially available Celox hemostatic granules. In conclusion, the biocompatible SA-CZ DHP exhibited rapid and effective management of excessive blood loss. It is also pertinent to note that the developed formulation could be a cost-effective alternative to its commercial counterparts.

Post-Traumatic Renal Artery Pseudoaneurysm Managed Successfully with Angioembolization

Renal artery pseudoaneurysm is a rare complication of blunt renal trauma. Super-selective angioembolization is aminimally invasive, effective procedure to manage traumatic renal artery pseudoaneurysm, in patients who are hemodynamicallystable. We report our experience in the management of patients with post-traumatic bleeding pseudoaneurysm withangioembolization. Materials and methods: We retrospectively reviewed the inpatient and outpatient records and imagingdata of our hospital, of all patients with history of blunt injury to kidneys, admitted with massive hematuria and underwentangioembolization to control the bleeding. Results: During the study period, 3 patients (all male) with a mean age of 26.66 yearspresented to us with blunt injury abdomen. Contrast computed tomography (CT) revealed Grade IV renal injury in 2 patientsand Grade V injury in 1 patient. Focal intensively enhancing areas were noted at the site of renal parenchymal lacerationssuggestive of pseudoaneurysms. Super-selective catheterization was performed and embolization done using 50% N-butyl-2-cyanoacrylate (NBCA) + Lipiodol. Conclusions: Angioembolization, a radiographic intervention, is an effective and minimallyinvasive technique to stop active bleeding from renal artery pseudoaneurysms.

A Visible Light Cross-Linked Underwater Hydrogel Adhesive with Biodegradation and Hemostatic Ability.

Hydrogel adhesives with integrated functionalities are still required to match their ever-expanding practical applications in the field of tissue repair and regeneration. A simple and effective safety strategy is reported, involving an in situ injectable polymer precursor and visible light-induced cross-linking. This strategy enables the preparation of a hydrogel adhesive in a physiological environment, offering wet adhesion to tissue surfaces, molecular flexibility, biodegradability, biocompatibility, efficient hemostatic performance, and the ability to facilitate liver injury repair. The proposed one-step preparation process of this polymer precursor involves the mixing of gelatin methacryloyl (GelMA), poly(thioctic acid) [P(TA)], poly(acrylic acid)/amorphous calcium phosphate (PAAc/ACP, PA) and FDA-approved photoinitiator solution, and a subsequent visible light irradiation after in situ injection into target tissues that resulted in a chemically-physically cross-linked hybrid hydrogel adhesive. Such a combined strategy shows promise for medical scenarios, such as uncontrollable post-traumatic bleeding.

THROMBOPHLEBITE POST-TRAUMATIQUE : A PROPOS DE TROIS CAS POST-TRAUMATIC THROMBOPHLEBITIS: ABOUT A THREE CLINICALS CASES

Abstract Introduction: Cranial post-traumatic cerebral thrombophlebitis is a rare form of cerebrovascular event. It is a diagnostic and therapeutic emergency, often underdiagnosed. Patients and observations: We report below a retrospective study on clinical records of three patients, with extremes ranging from 15 to 70 years, without pathological history, all struck by cars on public roads and hospitalized for the management of benign head injuries. Computed tomography scan (CT) without injection was performed in the three patients objectifying post-traumatic cranial lesions: extradural hematomas, intraparenchymal hematomas, pneumocephaly and contusions with doubt on CT confirmed by CT with injection of contrast product. Treatment with low molecular weight heparins (60 IU/Kg/12 h) with anti-vitamins K relay with strict clinical, biological and radiological monitoring, associated with motor physiotherapy for one case, allowed good clinical improvement. Conclusion: The diagnosis of post-traumatic cerebral vein thrombosis remains difficult to confirm by brain imaging and poses a management dilemma between effective anticoagulation and post-traumatic bleeding lesions.

Prophylaxis and Treatment of Bleeding or Thrombosis with Fibrinogen Concentrate (Fibryga) in Patients with Congenital Hypofibrinogenemia or Dysfibrinogenemia

Congenital fibrinogen disorders (CFDs) are rare and make up approximately 0.6% of all inherited bleeding disorders. Two subtypes include a quantitative deficiency of fibrinogen, congenital afibrinogenemia (CA), congenital hypofibrinogenemia (CH), and qualitative defect of the fibrinogen molecule, congenital dysfibrinogenemia (CD). Patients with CD may have a thrombotic as well as a hemorrhagic disease phenotype. In the past, fresh frozen plasma or cryoprecipitate were the only options available for treatment and prevention of bleeding in patients with CFD. Today in the US, human plasma-derived concentrates (FIBRYGA, Octapharma, Lachlen, Switzerland, and RiaSTAP, CSL, Melbourne, Australia) are available and considered safe and effective treatment options for CD and CH. Guidelines for the treatment and prevention of bleeding is not established for CFDs, and especially for CD. We present eight clinical cases of patients with hypo- or dysfibrinogenemia that were effectively treated with a pooled, plasma-derived fibrinogen concentrate (FIBRYGA) either prophylactically for elective or urgent surgery, or post-traumatic injury. The mean age of patients treated was 34 years (min-max 8-70 years). Three patients were male and five, female. Four patients had CH and four, CD. FIBRYGA was used to prophylactically treat a total of ten surgical procedures and two post-traumatic events in these patients. Dosing of FIBRYGA was based on the goal peak plasma fibrinogen concentration and the manufacturer's prescribing information, but modified to align with local laboratory reference ranges for the functional fibrinogen test. No acute or delayed infusion reactions (nausea, fever, rigors, headache) and no hypersensitivity reactions were noted. One patient developed two adverse events, one thrombotic and one hemorrhagic. This patient underwent left, above the knee amputation (AKA) and had a complicated postoperative period due to her multiple comorbidities including type 2 diabetes, hypertension, and long standing, poorly-controlled, severe peripheral arterial disease. She presented nineteen days after receiving FIBRGYA with a PE and multiple DVTs. Fifty-nine days later she presented with wound dehiscence and underwent an extensive excisional debridement with postoperative bleeding deemed to be secondary to her strap sliding during surgery and acting as a tourniquet for venous blood flow. For the majority (86%) of our patients described here with CH and CD, FIBRYGA was well tolerated and effective in preventing post procedural or post traumatic bleeding complications. The post procedural bleeding noted in one patient may have been due to inadequate fibrinogen concentration or other comorbid conditions. Further clinical studies are needed to determine the role of FIBRGYA and other HFC in the treatment of patients with CFD, especially those with CD.

Intramuscular administration of tranexamic acid in a large swine model of hemorrhage with hyperfibrinolysis.

Traumatic injury with subsequent hemorrhage is one of the leading causes of mortality among military personnel and civilians alike. Posttraumatic hemorrhage accounts for 40% to 50% of deaths in severe trauma patients occurring secondary to direct vessel injury or the development of trauma-induced coagulopathy (TIC). Hyperfibrinolysis plays a major role in TIC and its presence increases a patient's risk of mortality. Early therapeutic intervention with intravenous (IV) tranexamic acid (TXA) prevents development of hyperfibrinolysis and subsequent TIC leading to decreased mortality. However, obtaining IV access in an austere environment can be challenging. In this study, we evaluated the efficacy of intramuscular (IM) versus IV TXA at preventing hyperfibrinolysis in a hemorrhaged swine. Yorkshire cross swine were randomized on the day of study to receive IM or IV TXA or no treatment. Swine were sedated, intubated, and determined to be hemodynamically stable before experimentation. Controlled hemorrhaged was induced by the removal of 30% total blood volume. After hemorrhage, swine were treated with 1,000 mg of IM or IV TXA. Control animals received no treatment. Thirty minutes post-TXA treatment, fibrinolysis was induced with a 50-mg bolus of tissue plasminogen activator. Blood samples were collected to evaluate blood TXA concentrations, blood gases, blood chemistry, and fibrinolysis. Blood TXA concentrations were significantly different between administration routes at the early time points but were equivalent by 20 minutes after injection, remaining consistently elevated for up to 3 hours postadministration. Induction of fibrinolysis resulted in 87.18 ± 4.63% lysis in control animals, compared with swine treated with IM TXA, 1.96 ± 2.66% and 1.5 ± 0.42% lysis in the IV TXA group. In the large swine model of hemorrhage with hyperfibrinolysis, IM TXA is bioequivalent and equally efficacious in preventing hyperfibrinolysis as IV TXA administration.

Significant post-traumatic hemorrhage from a submandibular gland injury: a case report

Significant post-traumatic hemorrhage from a submandibular gland injury: a case report

Clinicopathological Parameters of Haemophilia Patients at a Tertiary Care Centre in Northern India.

Haemophilia affects a large number of people all over the world, yet very little is known about the clinical manifestations and diagnostic protocols of the condition in areas with limited access to resources in developing countries. Understanding the clinical spectrum and diagnostic approach will help with the design of measures to address the situation in these places. The primary objective of this study was to examine the clinicopathological parameters of haemophiliacpatients. From the departmental archive, a thorough history of each patient was retrieved, including values of bleeding time, prothrombin time, activated partial prothrombin time, and percentage of specific factor activity. Out of a total of 385 cases over the period of six years, 86.75% were classified as haemophilia Aand 13.25% of cases were diagnosed as haemophilia B. In terms of the severity of the disease, 44.93% were classified as severe, 42.08% as moderate, and 12.99% as mild. Joint bleeding was the first and most typical clinical manifestation of the disease, accounting for 34.80% of cases, followed by ecchymosis (23.12%), post-traumatic bleeding (12.73%), epistaxis (12.20%), and gum bleeding (8.05%). 1.56% of patients had a positive screening test for the hepatitis C virus, followed by 1.30% for HIV and 0.78% for hepatitis B surface antigen. In the presence of joint bleeding, ecchymosis, and post-traumatic bleeding in an otherwise healthy individual, a clinician should be alerted to the possibility that the patient has haemophilia and should request a work-up for the bleeding disorder.

Post-traumatic bleeding in a giant perivascular space.

Post-traumatic bleeding in a giant perivascular space.

Delayed post-traumatic intractable epistaxis due to pseudoaneurysms in concha bullosa: a case report

BackgroundDelayed post-traumatic bleeding at various sites is known due to vascular abnormalities related to structural changes in the vessel walls, in the form of pseudo aneurysms and arteriovenous malformations. Delayed epistaxis following facial trauma is a distinct entity that presents as recurrent episodes of bleeding from the nose. History of trauma is important to differentiate it from idiopathic intractable epistaxis, the management of which is less dramatic in the beginning in the form of endoscopy and electrocauterization. However, uncontrolled post-traumatic delayed epistaxis usually requires embolization. We report a rare case of intractable epistaxis associated with multiple pseudoaneurysms (PA), due to bleeding inside concha bullosa, where even embolization was unsuccessful.Case presentationA 25-year-old male patient presented to casualty and was referred to the Otorhinolaryngology department for recurrent profuse bleeding from left nasal cavity, where conservative measures like nasal packing, and electrocauterization did not help. Patient had a history of fall from height with facial bone fractures 1 month back. Angiography revealed blush with dilatation (pseudoaneurysms) in the nasal branches of internal maxillary arteries, ascending pharyngeal and labial arteries and embolization was done in the Interventional Radiology Department. Post-embolization, the patient again developed massive epistaxis. The patient was explored under general anaesthesia, to find out the site of bleed by nasal endoscopy. Collected blood was found in the left concha bullosa. Conchoplasty of the left middle turbinate was done with cauterization of bleeding vessels. The patient had no further epistaxis and was discharged in stable condition. He is asymptomatic for the last 6 months.ConclusionPost-traumatic pseudoaneurysms is a rare cause of delayed epistaxis following nasal trauma. Angiography helps in the localization of the source of bleeding inside nasal cavity and can identify pseudoaneurysmal dilatations of vessels. Our case highlights the importance of hidden bleeding points inside concha bullosa as a source of intractable epistaxis unresponsive to embolization.

Massive transfusion protocol.

The management of severe traumatic bleeding includes damage control resuscitation procedures including, in addition to surgical bleeding control, the application of the massive transfusion protocol. The aim of this paper is to present the massive transfusion protocol and selected scoring systems for an early detection of patients with severe post-traumatic bleeding. The use of a standardized protocol to activate the massive transfusion protocol reduces lethality due to severe traumatic bleeding and the consumption of blood products in trauma centers.

Morphologic, Hemostasiologic and Hemostatic Aspects of Systemic Application of Exogenous Fibrin Monomer in Model of Posttraumatic Bleeding with Underlying Intake of Warfarin

INTRODUCTION: Earlier, an ability of exogenous fibrin monomer (FM) introduced at low doses to considerably limit posttraumatic blood loss was established by us on an experimental model of warfarin coagulopathy in vivo. However, the morphologic peculiarities of fibrin formation in the wound area were not considered.&#x0D; AIM: To compare morphologic, hemostasiologic and hemostatic data based on the results of systemic application of exogenous FM to interpret their effects in the model of posttraumatic bleeding with the underlying intake of warfarin.&#x0D; MATERIALS AND METHODS: In the work, Chinchilla male rabbits were used. A comparative analysis of hemostasiologic effects and of morphologic picture of the surface of the liver in the wound area was conducted after a dosed trauma, with a preliminary systemic introduction of FM (0.25 mg/kg intravenously) or a concentrate of prothrombin complex factors (40 IU/kg intravenously) with the underlying intake of warfarin by animals (0.40.5 mg/kg/day per os for 2 weeks).&#x0D; RESULTS: Introduction of FM in warfarinised animals in the conditions of a dosed experimental liver injury promoted a hemostatic effect comparable with that of a concentrate of prothrombin complex factors. Both hemostatic drugs led to intense fibrin formation that reduced posttraumatic blood loss. The use of FM was associated with increase in the thickness of thrombotic deposits and fibrin fibers in the wound surface in comparison with placebo by 4.0 and 1.6 times, respectively (р 0.000001). This process actively involved platelets, which led to 1.7 times reduction of their quantity in the lumen of the blood vessels in the wound vicinity (р 0.0002). No effect of FM on systemic hemostatic reactions in venous blood was found, in contrast to concentrate of prothrombin complex factors.&#x0D; CONCLUSION: Exogenous FM can produce a local hemostatic effect in the conditions of dosed experimental trauma and coagulopathy induced by warfarin intake. The hemostatic effect was mediated by intense thrombosis on the wound surface with the active recruitment of platelets in the process. The peculiarities of the demonstrated effects of FM may be mediated though the mechanisms of its action that have not yet been identified, which necessitates continuation of the research in this direction.