Nerve stimulation a potential new treatment for severe blood loss shock

MANHASSET, NY  –  In a study published in the March issue of Critical Care Medicine, scientists at The Feinstein Institute for Medical Research and the department of neurosurgery at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, describe their discovery that stimulation of the trigeminal nerve – the nerve which supplies feeling to the face – can reverse hemorrhagic shock due to acute blood loss and improve survival in an animal model. This therapeutic approach could potentially represent a paradigm shift in the way that this deadly condition is managed in the future.

In the study, Feinstein Institute assistant professor Chunyan Li, PhD, and her team present a novel resuscitation approach of trigeminal nerve stimulation (TNS), a form of bioelectronic medicine, to amend the adverse consequences of acute blood loss, reverse hemorrhagic shock, and improve survival.

“Our research supports that bioelectronic medicine is a promising treatment for bleeding and its resulting impact on the body,” said Dr. Li. “In this study, we show for the first time that trigeminal nerve stimulation has the potential to aid in maintaining blood pressure and extending the life of hemorrhagic shock victims.”

Hemorrhagic shock is one of the major causes of early death from trauma, accounting for around 40 percent of deaths, of which 33 to 56 percent occur before the patient even reaches a medical facility. Intravenous fluid therapy and blood transfusion is still the cornerstone of treating hemorrhagic shock. However, in addition to the controversies that surround optimal fluid choices, these interventions are usually not immediately available, resulting in poorer outcomes and increased mortality. Therefore, newer strategies are needed to manage patients suffering from hemorrhagic shock before they can receive definitive care.

“With promising early results, we will further explore how trigeminal nerve stimulation may serve as a new way to provide early resuscitation to patients before they are brought to a trauma center,” said Raj K. Narayan, MD, Northwell Health’s senior vice president and executive director of neurosurgery, Feinstein Institute professor, and senior author of the paper. There are also other related conditions that may benefit from this strategy.”

The autonomic nervous system is critical in the regulation of internal organs, maintaining their vital functions and homeostasis. However, the balance of the autonomic nervous system may be overwhelmed in extreme pathophysiological states such as hemorrhagic shock. For this study, using an animal model, researchers showed that TNS significantly increased short-term survival without any fluid resuscitation. As compared to 0 percent survival in control animals with severe hemorrhagic shock, in the trigeminal nerve stimulation group the 60 minutes survival was 90 percent. TNS showed strong co-activation of the sympathetic and parasympathetic nervous system, with improved brain perfusion and controlled blood pressure. TNS also decreased systemic inflammation.

“These findings propose a new therapeutic approach to treating this deadly condition,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute.

This research was supported by the US Army Medical Research and Materiel Command (USAMRMC). To view the paper, click here.

About the Feinstein Institute

The Feinstein Institute for Medical Research is the research arm of Northwell Health, the largest healthcare provider in New York. Home to 50 research laboratories and to clinical research throughout dozens of hospitals and outpatient facilities, the Feinstein Institute includes 4,000 researchers and staff who are making breakthroughs in molecular medicine, genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we empower imagination and pioneer discovery, visit FeinsteinInstitute.org.

About the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Established in 2008, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell was founded by two equal partners: Hofstra University and Northwell Health. The School of Medicine is built upon the strong clinical and graduate medical education programs of Northwell, as well as the robust research and academic programs of both Hofstra and Northwell’s Feinstein Institute for Medical Research. For three years in a row, the Zucker School of Medicine has been recognized among the top medical schools nationwide for medical research (2017, 2018, 2019 U.S. News & World Report’s Best Graduate Schools). The institution comprises more than 3,000 faculty members across 25 academic departments and enrolls a diverse community of over 400 students. For more information, visit medicine.hofstra.edu.

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David Robbins
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