A novel approach to controlling bleeding, dubbed the 'neural tourniquet,' is showing promise in both surgical and postpartum settings. Scientists at the Feinstein Institutes for Medical Research are pioneering this technique, which involves stimulating the vagus nerve to enhance the body's natural blood clotting mechanisms. This could significantly reduce the risk of excessive bleeding during surgery and postpartum hemorrhage, a leading cause of maternal deaths worldwide.
The key to this innovative method lies in the vagus nerve, a complex neural pathway connecting the brain to various organs. By delivering precise electrical pulses to the vagus nerve, researchers can trigger a cascade of biological responses that ultimately prepare the body to combat blood loss more effectively.
How the Neural Tourniquet Works
Dr. Jared Huston, Director of Trauma Research for the Department of Surgery at Northwell Health, explains that stimulating the vagus nerve activates immune cells in the spleen. These activated cells, in turn, prompt platelets—the primary blood cells involved in clotting—to become more responsive to potential injuries. "Once the vagus nerve is activated, it sends a signal to the spleen where your platelets are stored," says Dr. Huston. "Your platelets are your main blood cells involved in clotting, and it activates those platelets or prepares those platelets to activate once they sense an injury anywhere in the body."
Promising Results from Preclinical and Clinical Studies
Initial research, conducted on mice and pigs, demonstrated significant reductions in bleeding following vagus nerve stimulation. Subsequent human trials have confirmed similar results, with volunteers showing increased markers of platelet activation in their blood samples after receiving targeted nerve stimulation. Dr. Huston’s prior preclinical research indicates that vagus nerve stimulation can decrease traumatic blood loss by up to 75 percent.
Addressing a Critical Medical Need
Surgical bleeding remains a significant challenge in modern medicine, with approximately 1.5 percent of surgeries experiencing complications related to excessive blood loss. Traditional methods, such as sutures and tourniquets, are effective in addressing bleeding after it occurs. However, the neural tourniquet offers a proactive approach, potentially preventing excessive bleeding before it starts.
Clinical Trial and Future Implementation
The ongoing clinical trial, sponsored by Five Liters, is evaluating whether vagus nerve stimulation alone is sufficient to enhance blood clotting. The device used in the trial loops over the left ear, delivering stimulation to the nervous system. If the trial proves successful, the neural tourniquet could be implemented in hospitals across the country, offering an additional layer of protection for patients undergoing surgery and women in labor.
A Potential Game Changer
"We view this as a game changer in terms of treating bleeding and bleeding disorders," says Huston. "This is the new treatment to do that, and we think it can affect not only trauma surgery, but pretty much every general surgical procedure that’s done. This could be used beforehand to try to decrease the risk of bleeding during surgery and after surgery, not to mention in childbirth."
