Massive hemorrhages are often deadly. Can a perfume ingredient stop the bleed and save lives? (Dimethyl malonate)

Medical Xpress / Tulane University / Science Advances ^ | June 14, 2023 | Sarah Abdullah et al

[ConservativeMind]

The chances of surviving massive blood loss from a traumatic injury are around 50%. To survive, a patient needs two things to happen quickly: a large infusion of blood and coagulation at the wound to stop the bleeding.

The problem is one of these solutions prevents the other. Introducing a large amount of blood to those suffering a massive hemorrhage impairs the blood's ability to clot, a condition known as coagulopathy.

Researchers have uncovered the cause of coagulopathy in trauma victims receiving a blood infusion. They also found that dimethyl malonate—often used in perfume manufacturing—has the potential to stop coagulopathy during a massive hemorrhage.

"Coagulopathy of trauma is a major contributor to mortality, but no treatment has shown to be fully effective," said Olan Jackson-Weaver, Ph.D. "We were getting 60% mortality with our animal model. With dimethyl malonate, we got zero percent mortality, and the coagulopathy completely went away."

Recent studies have shown that coagulopathy during massive hemorrhage treatment is most likely caused by the shedding of the glycocalyx, a barrier of sugars that surrounds and protects cells. In blood vessels, the glycocalyx lines the vessel walls and prevents blood from clotting.

The study found that, during blood loss, a person's cells lack the oxygen to metabolize succinate, a key part of the cell's energy-generating cycle. Unable to be metabolized, the succinate builds up. When a large amount of blood is infused into a trauma victim—the succinate is metabolized too quickly, which leads to a change in the structure of the plasma membrane lipids. This exposes the glycocalyx, allows it to be chewed up by enzymes, and mixes the shreds into the bloodstream, where it prevents clotting.

In animal models, dimethyl malonate was effective at inhibiting excessive cellular metabolism, which prevented the glycocalyx from shedding and causing coagulopathy.

[ConservativeMind]

No ping list on this, as it’s not ready for prime time, but it sounds like a wonderful future option to keep loved ones alive during a time of tragedy.

[LukeL]

I have watched enough of the real life trauma shows to know that people often fall victim to the triad of death and will ooze blood out of every vessel despite rapid transfusions blood products.

[grobdriver]

QuickClot gauze, CAT tourniquet.

[Eagles6]

Interesting.