The Groundbreaking Technology Behind QuikClot® Hemostasis Products
The Key Ingredient: KAOLIN – A Small Mineral with Huge Stopping Power
How an inert mineral can create a powerful, natural, and stable clot.
The third generation of QuikClot products, each designed for use by healthcare professionals, are composed of rayon/polyester gauze that has been impregnated with kaolin, a white aluminosilicate. The gauze does not contain botanicals or materials from animal or human sources.
It has been known for many years that the intrinsic blood clotting pathway is inititiated by negatively charged surfaces such as kaolin or glass1. Kaolin is utilized routinely in reagents that are used to assay blood clotting times by clinical laboratories that follow procedures that are published by the College of American Pathologists (CAP).2
Kaolin is an inert mineral and it promotes clotting by two main modes of action:
- Kaolin promotes the activation of Factor XII (FXII) in the presence of kallikrein and high molecular weight kininogen.3 Activated FXII initiates the intrinsic clotting pathway via the activation of Factor XI.3 Activated FXI continues the coagulation pathway that ends with the formation of a fibrin clot.2
- Kaolin promotes the activation of platelet-associated FXI4 and it is a distinct and separate molecule from plasma FXI.5 Activated platelet-associated FXI initiates the intrinsic clotting pathway in normal and FXII deficient patients.4
Kaolin-based QuikClot gauze has been subjected to safety and efficacy studies that were performed by the US Army Institute of Surgical Research (USAISR) and the Naval Medical Research Center. Arterial incisions were made in the USAISR study and the wounds were treated with kaolin-based QuikClot gauze, placebo QuikClot gauze (without kaolin), HemCon gauze, Celox-D, and TraumaStat.6 Kaolin-based QuikClot gauze was found to be the most effective product among the dressings tested in the USAISR study allowing the least amount of hemorrhage and resulted in the highest survival rate in the animals tested.6
The Tactical Combat Casualty Care (TCCC) committee has revised the TCCC guidelines to state the Combat Gauze (the kaolin-based QuikClot product) is the first line of treatment for life-threatening hemorrhage on external wounds that are not amendable to tourniquet placement. The decision to update the TCCC guideline concerning Combat Gauze was based on the test results from the USAISR study.6
The hemostasis time for kaolin-based QuikClot gauze was typically five minutes according to a clinical study that was performed on 40 consecutive patients that had been subjected to femoral diagnostic or interventional procedures.7
In conculusion, kaolin-based QuikClot gauze products are manufactured with safe and proven materials for use as hemostatic agents in the temporary control of traumatic bleeding. The Department of Defense and the National Institute of Health are funding research to explore other applications of QuikClot in the healthcare markets because QuikClot has been accepted by all branches of the US military.
Blood Coagulation Pathways8
1. Margolis, J; The Kaolin clotting Time: A rapid One-Stage Method for Diagnosis of Coagulation Defects; 1958; J Clin Pathol; Vol 11; 406-409
To learn about the QuikClot generation 1 and generation 2 zeolite products, click here.
2. Kottke-Marchant, MD, PhD; An Algorithmic Approach to Hemostasis Testing; CAP Press; 2008
3. Griffin, JH; Role of Surface in Surface-dependant Activation of Hageman Factor XII; Proc Natl Acad Sci; 1978; Vol 75; 1998-2002
4. Walsh, PN; The Effects of Collagen and Kaolin on the Intrinsic Coagulant Activity of Platelets; 1972; Brit J Haem; Vol 22; 393-405
5. Tuszynski et al; Factor XI Antigen and Activity in Human Platelets; 1982; Blood; Vol 59; 1148-1156
6. Kheirabadi, BJ; Determination of Efficacy of New Hemostatic Dressings in a Model of Extremity Arterial Hemorrhage in Swine; J Trauma; 2009; Vol 67; 450-460
7. Trabattoni et al; A New Kaolin-Based Hemostatic Bandage Use after Coronary Diagnostic and Interventional Procedures; Inter J Cardiol; 2010; online
8. Wikipedia (http://en.wikipedia.org/wiki/Coagulation)