SUMMARY

Controlling hemostatic function is of critical importance in ensuring survival after an injury to the vasculature. Uncontrolled hemorrhage is often fatal, an occlusive clot must quickly form at the site of injury to prevent exsanguination. While much work has been done on the kinetics and biological basis for hemostasis, the role of mechanics, specifically fluid mechanics, on regulating the hemostatic response to vascular injury remains unexplored. In this work, I characterize the fluid mechanics of arterial injuries to determine the shear conditions present. I then demonstrate that shear induced platelet aggregation plays a key role in the formation of clots for most vascular bleeding. Platelet and Von Willebrand Factor combine by pathologically high shear rates and are necessary for clotting. Following this, I develop a Point-Of-Care platelet function test to distinguish normal and abnormal shear induced platelet aggregation function in level I and II trauma patients. I seek to utilize the results of this trial to explore how changes in patient shear induced platelet aggregation function are affected following trauma, in order to develop novel treatment strategies. Finally, I apply our knowledge of the mechanics of hemorrhagic flows to demonstrate how variable levels of Von Willebrand Factor and platelets may be used to modulate hemostatic function. The results of this work will expand on the nature of hemorrhagic flows, and on their mechanistic relation to hemostasis. They will also help guide surgical treatment of hemorrhagic injuries and the development of methods to modulate hemostatic function.