Calcium content mediated hemostasis of calcium-modified oxidized microporous starch

Blood coagulates are closely related to calcium ions (coagulation factor IV), and calcium-doped biomaterials have been reported to be effective in hemostasis. However, the effects exerted by calcium on hemostatic agents have not been previously investigated. The aims of this work were to develop calcium-modified oxidized microporous starch (CaOMS) with controllable calcium contents and to explore the relationship between calcium content and hemostatic effects. The results showed that low calcium content promoted coagulation, while high calcium content inhibited coagulation. CaOMS3 with 2.2 mg/g calcium content was optimal because of its excellent water absorption performance that enhanced physical coagulation, the rapid initiation of coagulation cascade reactions, and the enhanced chemical coagulation by RBC aggregation and platelet activation. The synergistic effects of chemical activation and physical absorption endowed CaOMS with the potential to control internal organ bleeding. These results suggested that CaOMS may be a promising hemostatic agent with wide spread applications.