Scientists unveil a 'neural tourniquet' that can stop bleeding by stimulating nerves

Tapping the vagus nerve promotes blood clotting, new research shows.

These findings are the first evidence in humans of a “neural tourniquet“or a brain-based signaling pathway that could reduce bleeding,” said the study’s co-author Dr. Jared HustonTrauma surgeon at the Firestein Institutes for Medical Research at Northwell Health in New York.

If a future clinical trial directly shows that nerve stimulation reduces blood loss, the technique could be used before elective surgeries to protect patients from excessive bleeding, Huston told Live Science.

About 1.5% of operations are complicated by bleeding or excessive blood loss, and all surgeries involve some degree of bleeding. Surgeons currently rely on sutures, bandages, etc Tourniquets – Devices that stop blood flow to parts of the body – to stop bleeding.

But Huston wondered whether the surgery would be safer if the chances of blood coming out in the first place were reduced. “Preventing a problem is always better than fixing it after the fact,” he said.

Related: How much blood is there in the human body?

Huston and his colleagues first wondered almost 20 years ago whether the vagus nerve could promote blood clotting The nerve has been found to modulate inflammation. The vagus nervethat originates in the brain and branches out to other organs controls this Parasympathetic nervous system – the rest-and-digest counterpart to “fight or flight” sympathetic nervous system.

First experiments on mice and pigs showed that stimulation of the vagus can actually reduce blood loss after a small cut. “We then spent almost a decade figuring out exactly how it works,” Huston said.

Last year, Huston’s team showed it that stimulation of the vagus nerve activates a type of immune cell called T cells in the body spleenthe organ that helps filter germs and old cells from the blood. These T cells then activate platelets in the spleen; Platelets are the cell fragments that trigger the formation of blood clots.

Upon reentering the bloodstream, the primed platelets are better able to respond to injury-related signals. In mice with hemophiliaA condition in which blood cannot clot properly, nerve stimulation reduced bleeding, the team found.

To test whether the same mechanism exists in humans, Huston’s team worked with the Dallas-based biomedical company Five liters to recruit healthy volunteers. To do this, they used an approved device Zap the ear branch of the vagus nervewhich runs behind each person’s ear for 30 minutes. They collected blood samples before and after treatment.

After vagus nerve stimulation, the volunteers’ blood contained higher concentrations of markers of platelet activation.

These results were published Nov. 13 on the National Library of Medicine website ClinicalTrials.govshowed for the first time “that there is a neural tourniquet pathway in humans,” Huston said. “And it appears that we can non-invasively activate this neural tourniquet pathway.”

While the results of animal studies so far are “very intriguing,” more work needs to be done to show that vagus nerve stimulation can actually stop bleeding in humans. Peder OlofssonProfessor of bioelectronic medicine at the Karolinska Institute in Stockholm, Sweden, told Live Science.

“Ultimately, measurements of bleeding duration, bleeding volume and patient outcomes will be crucial” to demonstrate the clinical value of activating the vagus nerve through the skin, said Olofsson, who was not involved in the study.

Huston agreed. “The next study needs to look at an actual clinical condition where patients are bleeding in one way or another,” he said.

Another problem is showing that the stimulators can deliver consistent results, Olofsson noted. “Non-invasive stimulators” — although they are much quicker and easier to use than implanted stimulators — “often demonstrate less consistent physiological effects.”

Vagus nerve stimulation is already widely used epilepsy And depressionTherefore, the risk of side effects is likely low, Huston added. If his findings can be replicated and expanded in larger studies, surgeons could perform a brief period of vagal nerve stimulation before planned surgeries.

“We give antibiotics so you don’t get an infection during the operation. We give painkillers preventatively so the pain is less,” Huston said. “What’s missing is a way to try to prevent bleeding in advance in a normal, healthy person undergoing surgery. This is a huge unmet need.”

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Scientists unveil a ‘neural tourniquet’ that can stop bleeding by stimulating nerves

ByAmelia Journalton

By Amelia Journalton

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