{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T15:29:24Z","timestamp":1771514964534,"version":"3.50.1"},"reference-count":44,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Military, Veteran and Family Health"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:p>LAY SUMMARY<\/jats:p>\n                  <jats:p>The efficacy of current hemostatic technologies is limited by several factors. Outward blood flow washes hemostatic drugs away from the wound, and hemostatic drugs often require focus, training, and time to use correctly, are highly specific to one type of injury, or pose severe safety risks. CounterFlow is a novel product that could potentially save military and civilian lives by stopping heavy bleeding from a variety of organs and other bodily locations that current technology cannot easily treat. Upon contact with blood, CounterFlow releases bursts of gas to safely self-propel bio-degradable clot-forming and clot-stabilizing drugs against blood flow, delivering them to the source of bleeding. This unique mechanism allows CounterFlow to be applied quickly to a wide assortment of wounds and to act effectively with little management after application. CounterFlow was tested in multiple animal models representing common and deadly bleeding scenarios, including internal bleeding, care under fire without compression, and surgical bleeding, and it was found to outperform current care options by stopping bleeds faster and increasing survival times. CounterFlow is also safe to use and biocompatible. This narrative review summarizes studies testing the effectiveness and safety of CounterFlow, discusses useful applications, and describes future plans for the product.<\/jats:p>","DOI":"10.3138\/jmvfh-2022-0014","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T15:10:04Z","timestamp":1673536204000},"page":"25-39","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy and safety of CounterFlow in animal models of hemorrhage"],"prefix":"10.3138","volume":"9","author":[{"given":"Nuoya","family":"Peng","sequence":"first","affiliation":[{"name":"Michael Smith Laboratories and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Departments of Surgery, Biochemistry, Biomedical Engineering, and Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States"},{"name":"Blood Research Institute, Versiti, Milwaukee, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han H.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Biochemistry, Biomedical Engineering, and Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States"},{"name":"Blood Research Institute, Versiti, Milwaukee, Wisconsin, United States"},{"name":"Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adele","family":"Khavari","sequence":"additional","affiliation":[{"name":"Michael Smith Laboratories and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Zhang-Gao","sequence":"additional","affiliation":[{"name":"Michael Smith Laboratories and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Tenn","sequence":"additional","affiliation":[{"name":"Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugh A.","family":"Semple","sequence":"additional","affiliation":[{"name":"Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo F.","family":"Cau","sequence":"additional","affiliation":[{"name":"Michael Smith Laboratories and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Beckett","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian J.","family":"Kastrup","sequence":"additional","affiliation":[{"name":"Michael Smith Laboratories and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Departments of Surgery, Biochemistry, Biomedical Engineering, and Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States"},{"name":"Blood Research Institute, Versiti, Milwaukee, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1696","reference":[{"key":"r1","doi-asserted-by":"crossref","first-page":"S431","DOI":"10.1097\/TA.0b013e3182755dcc","volume":"73","author":"Eastridge BJ","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"r2","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1097\/TA.0b013e318221147b","volume":"71","author":"Eastridge BJ","year":"2011","journal-title":"J Trauma Acute Care Surg"},{"issue":"6","key":"r3","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1097\/01.sla.0000259433.03754.98","volume":"245","author":"Holcomb JB","year":"2007","journal-title":"Ann Surg"},{"issue":"2","key":"r4","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1097\/TA.0b013e318160b9fb","volume":"64","author":"Kelly JF","year":"2008","journal-title":"J Trauma Acute Care Surg"},{"issue":"9","key":"r5","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.7205\/MILMED-D-12-00161","volume":"177","author":"Katzenell U","year":"2012","journal-title":"Mil Med"},{"issue":"2","key":"r6","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1111\/trf.15161","volume":"59","author":"Eastridge BJ","year":"2019","journal-title":"Transfusion"},{"issue":"1","key":"r7","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s13049-016-0301-9","volume":"24","author":"van Oostendorp SE","year":"2016","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"4","key":"r8","first-page":"843","volume":"92","author":"Morrison JJ","year":"2012","journal-title":"Surg Clin"},{"key":"r9","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1503\/cjs.001815","volume":"58","author":"Tien H","year":"2015","journal-title":"Can J Surg"},{"issue":"3","key":"r10","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/CCM.0000000000002915","volume":"46","author":"Holcomb JB","year":"2018","journal-title":"Crit Care Med"},{"key":"r11","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13017-018-0181-6","volume":"13","author":"Ribeiro MAF","year":"2018","journal-title":"World J Emerg Surg"},{"issue":"6","key":"r12","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1177\/000313481808400650","volume":"84","author":"Wasicek PJ","year":"2018","journal-title":"Am Surg"},{"issue":"1","key":"r13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s40792-016-0260-4","volume":"2","author":"Okada Y","year":"2016","journal-title":"Surg Case Rep"},{"key":"r14","first-page":"13","volume":"7","author":"Peng HT","year":"2020","journal-title":"Mil Med Res"},{"issue":"9","key":"r15","doi-asserted-by":"crossref","first-page":"932","DOI":"10.7205\/MILMED-D-15-00049","volume":"180","author":"Chang JC","year":"2015","journal-title":"Mil Med"},{"issue":"6","key":"r16","doi-asserted-by":"crossref","first-page":"S118","DOI":"10.1503\/cjs.025011","volume":"54","author":"Savage E","year":"2011","journal-title":"Can J Surg"},{"key":"r17","unstructured":"Kragh JF, Murphy C, Dubick MA, et al. New tourniquet device concepts for battlefield hemorrhage control. US Army Med Dep J. 2011:38\u201348. Medline:21607905"},{"issue":"7","key":"r18","doi-asserted-by":"crossref","first-page":"799","DOI":"10.7205\/MILMED-D-12-00495","volume":"178","author":"Kragh JF","year":"2013","journal-title":"Mil Med"},{"issue":"8","key":"r19","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1136\/emj.2007.046359","volume":"24","author":"Lee C","year":"2007","journal-title":"Emerg Med J"},{"issue":"1","key":"r20","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.ejphar.2010.10.037","volume":"650","author":"Tran TP","year":"2011","journal-title":"Eur J Pharmacol"},{"issue":"9","key":"r21","doi-asserted-by":"crossref","first-page":"e1500379","DOI":"10.1126\/sciadv.1500379","volume":"1","author":"Baylis JR","year":"2015","journal-title":"Sci Adv"},{"issue":"3","key":"r22","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/SHK.0000000000000646","volume":"46","author":"Baylis JR","year":"2016","journal-title":"Shock"},{"key":"r23","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1016\/S0049-3848(16)30362-0","volume":"141","author":"Baylis JR","year":"2016","journal-title":"Thromb Res"},{"issue":"4","key":"r24","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1002\/lary.26408","volume":"127","author":"Baylis JR","year":"2017","journal-title":"Laryngoscope"},{"issue":"10","key":"r25","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1111\/jth.14526","volume":"17","author":"Baylis JR","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"5","key":"r26","doi-asserted-by":"crossref","first-page":"E693","DOI":"10.1055\/a-1374-5839","volume":"9","author":"Ali-Mohamad N","year":"2021","journal-title":"Endosc Int Open"},{"issue":"5","key":"r27","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.injury.2022.01.024","volume":"53","author":"Cau MF","year":"2022","journal-title":"Injury"},{"issue":"2","key":"r28","first-page":"S96","volume":"93","author":"Cau MF","year":"2022","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"r29","doi-asserted-by":"crossref","first-page":"585","DOI":"10.2165\/11209070-000000000-00000","volume":"72","author":"McCormack PL","year":"2012","journal-title":"Drugs"},{"issue":"7","key":"r30","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1111\/j.1538-7836.2009.03455.x","volume":"7","author":"Varga-Szabo D","year":"2009","journal-title":"J Thromb Haemost"},{"issue":"1","key":"r31","doi-asserted-by":"crossref","first-page":"11324","DOI":"10.1038\/s41598-019-47815-z","volume":"9","author":"Singh S","year":"2019","journal-title":"Sci Rep"},{"key":"r32","first-page":"S139","volume":"71","author":"Kheirabadi BS","year":"2011","journal-title":"J Trauma"},{"issue":"2","key":"r33","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/TA.0000000000000746","volume":"79","author":"John AE","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"r34","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1471-2482-14-111","volume":"14","author":"Echave M","year":"2014","journal-title":"BMC Surg"},{"issue":"2","key":"r35","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1055\/s-0031-1275255","volume":"21","author":"Valentine R","year":"2011","journal-title":"Skull Base"},{"issue":"13","key":"r36","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.3748\/wjg.v25.i13.1592","volume":"25","author":"Vitali F","year":"2019","journal-title":"World J Gastroenterol"},{"issue":"4","key":"r37","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.gtc.2014.08.005","volume":"43","author":"Song LMWK","year":"2014","journal-title":"Gastroenterol Clin North Am"},{"issue":"4","key":"r38","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1055\/s-0030-1256125","volume":"43","author":"Giday SA","year":"2011","journal-title":"Endoscopy"},{"issue":"1","key":"r39","doi-asserted-by":"crossref","first-page":"P103","DOI":"10.1016\/j.injury.2021.08.027","volume":"53","author":"Rezende-Neto J","year":"2021","journal-title":"Injury"},{"issue":"3","key":"r40","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/TA.0000000000000940","volume":"80","author":"Russo RM","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"r41","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1186\/cc2851","volume":"8","author":"Gutierrez G","year":"2004","journal-title":"Crit Care"},{"issue":"2","key":"r42","first-page":"316","volume":"66","author":"Kheirabadi BS","year":"2009","journal-title":"J Trauma"},{"issue":"2","key":"r43","first-page":"269","volume":"68","author":"Kheirabadi BS","year":"2010","journal-title":"J Trauma"},{"issue":"2","key":"r44","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/01.TA.0000105916.30158.06","volume":"57","author":"Wright JK","year":"2004","journal-title":"J Trauma"}],"container-title":["Journal of Military, Veteran and Family Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/utppublishing.com\/doi\/pdf\/10.3138\/jmvfh-2022-0014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T21:29:48Z","timestamp":1767821388000},"score":1,"resource":{"primary":{"URL":"https:\/\/utppublishing.com\/doi\/10.3138\/jmvfh-2022-0014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2,1]]}},"alternative-id":["10.3138\/jmvfh-2022-0014"],"URL":"https:\/\/doi.org\/10.3138\/jmvfh-2022-0014","relation":{},"ISSN":["2368-7924","2368-7924"],"issn-type":[{"value":"2368-7924","type":"print"},{"value":"2368-7924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}