Trauma remains the leading cause of mortality between the ages of 1 and 44 in the United States. Uncontrolled blood loss accounts for 50 % of all battlefield deaths and up to 25 % of civilian trauma deaths. This mortality is often the result of a severe clotting impairment known as acute traumatic coagulopathy. Therefore, hemorrhage control remains the a priori goal in the care of the critically injured patient. While great advances have been made in the resuscitation of the injured patient, attenuating bleeding and correction of coagulopathy remain vexing clinical problems. Current clotting treatments are plagued by concerns over excessive cost, poor stability, and safety issues.

In this defense, I present a silica nanoparticle (SNP) functionalized with polyphosphate (polyP) that mediates the body's natural clotting process. SNPs initiate the blood clotting system's contact pathway, while the endogenous short-chain polyP accelerates the common pathway via rapid formation of thrombin. This enhances the overall blood-clotting system, both by accelerating fibrin generation and by facilitating the regulatory anticoagulation mechanisms essential for hemostasis. Because of its low production cost, long-term stability at ambient conditions, and the potential to minimize side effects seen in current treatments, the polyP-SNP therapeutic has the possibility to enable the body to re-establish hemostasis after traumatic injury, preventing massive blood loss and saving lives.