Stimulating Vagus Nerve Prevents Blood Loss Following Surgery

Stimulating neural pathways is a potentially efficacious and safe way to prevent hemorrhagic complications following surgery and other invasive procedures, according to a new study.

Developed by researchers at the Feinstein Institute for Medical Research (Manhasset, NY, USA), the Neural Tourniquet is designed in the form of a wearable technology clipped to a patient’s ear, which will work by stimulating neural pathways leading to the spleen in order to activate the inflammatory reflex, thus allowing the brain to monitor and control systemic inflammatory mediators rapidly and directly. The stimulation of the efferent vagus nerve, for example, informs the brain of increases in systemic proinflammatory cytokine concentrations in the peritoneal cavity.

The efferent vagus nerve signaling also reaches the spleen through the splenic nerve, which then increases acetylcholine release from cholineacetyltransferase-positiveT cells. The acetylcholine can then inhibit proinflammatory cytokine production by stimulating the α7 nicotinic acetylcholine receptor subunit, activating circulating platelets and priming the coagulation system. Studies have shown that stimulation for as little as 60 seconds can induce clotting 50% faster and reduce the volume of blood loss by 50%.

Applications include reducing blood loss in the operating room (OR); slowing blood loss in trauma victims at accident scenes, and as a device to proactively curb blood loss in wounded soldiers on the battlefield. The Neural Tourniquet is being developed by the Feinstein Institute in conjunction with Battelle (Columbus, OH, USA), with data on the device being presented at the North American Neuromodulation Society (NANS) 19th annual meeting, held during December 2015 in Las Vegas (NV, USA).

“Our main goal at the Feinstein is to improve the health and wellbeing of people through scientific discovery,” said Christopher Czura, PhD, vice president of scientific affairs at the Feinstein Institute and co-inventor of the Neural Tourniquet. “We know that blood loss is a tremendous problem in a range of settings, and when we saw that our discoveries could change that, we knew we needed a partner to help bring that discovery to market. Battelle’s track record and approach make them a perfect partner.”

“At Battelle, we have a long history of developing innovative technologies that help advance the state of modern healthcare and save lives,” said Chad Bouton, a research leader specializing in Neurotechnology at Battelle. "Our deep experience in neurotechnology development for brain and nerve applications, such as our NeuroLife neural bypass technology launched last year, is what brought us together with the team at the Feinstein. We look forward to building a partnership geared towards launching yet another innovative, life-saving technology.”

Bioelectronic medicine involves screening for nerves that control a target organ, and then designing devices that control those nerves. The devices have the potential to deliver treatment specifically where it is required, versus a drug which typically is distributed throughout the body and causes side effects. The list of possible diseases, conditions, and injuries that bioelectronic medicine could treat includes cancer, hypertension, diabetes, Alzheimer's disease (AD), rheumatoid arthritis, organ transplantation, paralysis, and shock.

Related Links:
Feinstein Institute for Medical Research
Battelle
Vagus Nerve Stimulation Attenuates Traumatic Hemorrhage video