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首页> 外文期刊>Proceedings of the National Academy of Sciences of the United States of America >Ex vivo evaluation of a Tayor-Couette flow, immobilized heparinase I device for clinical application
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Ex vivo evaluation of a Tayor-Couette flow, immobilized heparinase I device for clinical application

机译：Tayor-Couette血流，固定化肝素酶I装置的离体评估，用于临床应用

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摘要

Effcient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1.5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermorr, gross necropsy and histopathology did not show any significant abnormalities in the kidnry, liver, heart, brain, and spleen.
机译：有效和安全的肝素抗凝治疗仍然是持续性肾脏替代疗法和急性肾衰竭患者间歇性血液透析的难题。为了使具有高出血风险的急性肾衰竭患者的肝素治疗更安全，我们建议通过固定的肝素酶I过滤器对回路进行局部肝素化。这项研究测试了基于泰勒-考特血流和同时分离/反应的设备在绵羊模型中去除肝素的功效和安全性。肝素酶I通过溴化氰活化固定在琼脂糖珠上。该设备被称为涡流血浆球反应器，由两个同心圆筒，45 ml灌注体积，用于血浆分离的微孔膜和一个外部隔室组成，固定化肝素酶I与血细胞分开流化。进行了手动白细胞和血小板计数，血细胞比容，总蛋白和纤维蛋白原测定。肝素水平通过全血再钙化时间（WBRT）间接测量。在没有溶血的情况下，涡流等离子体球反应器在体外回路中的肝素水平明显高于绵羊（设备入口WBRT为设备出口WBRT的1.5倍）。在长达2小时的手术中，反应器处理对全血细胞计数，血小板和蛋白质水平没有任何生理上的显着变化。进一步的病理检查，大体尸检和组织病理学检查未显示出绑架，肝脏，心脏，大脑和脾脏的任何明显异常。

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