To the issue of methodology of comparative study of the degree of hemostatic activity of topical hemostatic agents

Abstract

At present new drugs affecting the hemostasis system and locally affecting hemostatic agents are being intensively developed. New types of the developed substances require highly objective and precise comparative methods for efficiency measuring. However, despite the current situation, the choice of methods for assessing the haemostatic activity of drugs and hemostatic implants (both in clinical practice and in experiment) remains open. In this regard, the authors have analyzed most common modern methods, combinations of the evaluated hemostasis indicators and methods for studying hemostatic activity of drugs and implants (in vitro and in vivo); the advantages and disadvantages of these methods are described and their most effective combinations are proposed. The authors propose the algorithm for the selection of hemostatic agents developed for the purpose of their application in surgical interventions primarily on the parenchymal organs of the abdominal cavity. The algorithm is based on the phasing of using various techniques (I step - a screening study of physic-mechanical and hemostatic properties in vitro implant procedures, II step - the method of "acute" experience in vivo for determining bleeding time and blood loss volume, III step - the method of "chronic" experiment in vivo (investigation of expression of the animal tissue response to the implant after subcutaneous implantation and a simulated parenchymal injury of organs and so forth.), permitting to study comprehensively the hemostatic ability of the topical hemostatic implants and to avoid possible negative effects when they are used.