Abstract

The mammalian nervous system is essential to protecting the host against injury. Arguably the most important priority after traumatic injury is hemorrhage control. Herein we describe how the central nervous system helps limit bleeding and improve hemostasis via a vagus nerve mediated pathway termed the neural tourniquet. Activation of the neural tourniquet through electrical vagus nerve stimulation rapidly and significantly reduces blood loss and duration of bleeding in multiple experimental models of traumatic hemorrhage. These improvements in hemostasis are associated with accelerated clot formation specifically at sites of injury. The emerging field of bioelectronic medicine will allow physicians and scientists to harness the neural tourniquet and other endogenous protective mechanisms safely and noninvasively. Considering that bleeding is a significant contributor to morbidity and mortality following trauma, surgery, and other invasive procedures, the neural tourniquet has the potential to dramatically improve clinical outcomes for our patients.