Background: Bleeding is a leading cause of death in humans during trauma and surgery. Coagulation factor XII (FXII) is activated by silicates, including in hemostatic materials such as gauze used for hemorrhage control during trauma. Soils with a high silicon content accelerate clotting in humans and mice in a FXII-dependent manner.

Aims: To determine whether extra-terrestrial soil simulants (ETSS) and true meteorite samples are effective hemostatic agents due to their high silicon concentrations like terrestrial soils.

Methods: Several ETSS, their component minerals and crushed chondrite meteorites were assessed for hemostatic potential. A plasma turbidity-based clotting assay was first used to compare clot times of normal control plasma and plasma deficient in FXII when ETSS and true meteorites were added. Thrombin generation was measured by comparing plasma exposed to ETSS treated with or without corn trypsin inhibitor to inhibit FXII activity. Two ETSS and chondrite meteorites were loosely place on gauze and administered to a deep porcine liver bleed to assess clotting time and blood loss compared to plain gauze.

Results: ETSS significantly accelerated in vitro clot formation (p<0.01) and induced more thrombin generation in normal plasma, but not in FXII deficient plasma. Gauze loaded with ETSS, including chondrite meteorite, reduced blood loss in pigs following administration to deep liver lacerations: 25.52 mL +/- 5.34 mL (mean +/- SEM, n=18) compared to 69.47 mL +/- 25.45 mL (n=7) in normal gauze.

Conclusions: ETSS may be useful as an in situ material to promote hemostasis in future space missions such as on lunar and martian bases.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/extra-terrestrial-soils-activate-coagulation-factor-xii-and-manage-bleeding-in-a-porcine-model-of-liver-laceration-implications-for-hemorrhage-control-during-space-exploration/