Interventional micro-axial flow blood pump is widely used as an effective treatment for patients with cardiogenic shock. Hemolysis and coagulation are vital concerns in the clinical application of interventional micro-axial flow pumps. This paper reviewed hemolysis and coagulation models for micro-axial flow blood pumps. Firstly, the structural characteristics of commercial interventional micro-axial flow blood pumps and issues related to clinical applications were introduced. Then the basic mechanisms of hemolysis and coagulation were used to study the factors affecting erythrocyte damage and platelet activation in interventional micro-axial flow blood pumps, focusing on the current models of hemolysis and coagulation on different scales (macroscopic, mesoscopic, and microscopic). Since models at different scales have different perspectives on the study of hemolysis and coagulation, a comprehensive analysis combined with multi-scale models is required to fully consider the influence of complex factors of interventional pumps on hemolysis and coagulation.
【摘要】 目的 對市場上流通使用的血塞通注射液在溶血性方面的狀況進行考察與研究。 方法 按《中國藥典》2005年版一部附錄ⅩⅧ B中藥注射劑安全性檢查法應用指導原則和中藥、天然藥物刺激性和溶血性研究的技術指導原則，對11 個廠家共計27 批血塞通注射液每批次樣品制備4 個濃度，進行溶血實驗研究，并采用分光光度法（545 λ/nm）測定計算溶血率，比較各批次樣品的溶血率。 結果 不同廠家甚至同一廠家不同批次的血塞通注射液溶血率存在一定差異。 結論 在臨床使用中應注意用量，過量使用可能導致溶血引起的不良反應；同時，應注意溶血引起的臨床不良反應的觀測。【Abstract】 Objective To explore the hemolysis of Xuesaitong injection. Methods According to the Guiding Principles of safety tests on traditional Chinese medicine injection in Annex ⅩⅧ B, Chinese Pharmacopoeia, 2005 Edition 1, and Technical Guidelines of studies on the irritability and hemolytic activity of traditional Chinese medicine and natural medicine, a total of 27 samples of Xuesaitong injections (each sample was diluted into four concentrations) produced by 11 manufacturers had been examined. Spectrophotometry (545 λ/nm) was used to calculate the hemolytic rate. Results There was a certain difference in the hemolytic rate among several samples of Xuesaitong injections produced by different manufacturers, or even different batches by the same manufacturer. Conclusion The dosage of Xuesaitong injections should be noted in clinical use. Excessive use may lead to adverse reactions caused by hemolysis; at the same time, clinical adverse reactions caused by hemolysis should be observed.
An implantable axial blood pump was designed according to the circulation assist requirement of severe heart failure patients of China. The design point was chosen at 3 L/min flow rate with 100 mm Hg pressure rise when the blood pump can provide flow rates of 2-7 L/min. The blood pump with good hemolytic and anti-thrombogenic property at widely operating range was designed by developing a structure that including the spindly rotor impeller structure and the diffuser with splitter blades and cantilevered main blades. Numerical simulation and particle image velocimetry (PIV) experiment were conducted to analyze the hydraulic, flow fields and hemolytic performance of the blood pump. The results showed that the blood pump could provide flow rates of 2-7 L/min with pressure rise of 60.0-151.3 mm Hg when the blood pump rotating from 7 000 to 11 000 r/min. After adding the splitter blades, the separation flow at the suction surface of the diffuser has been reduced efficiently. The cantilever structure changed the blade gap from shroud to hub that reduced the tangential velocity from 6.2 m/s to 4.3-1.1 m/s in blade gap. Moreover, the maximum scalar shear stress of the blood pump was 897.3 Pa, and the averaged scalar shear stress was 37.7 Pa. The hemolysis index of the blood pump was 0.168% calculated with Heuser’s hemolysis model. The PIV and simulated results showed the overall agreement of flow field distribution in diffuser region. The blood damage caused by higher shear stress would be reduced by adopting the spindle rotor impeller and diffuser with splitter blades and cantilevered main blades. The blood could flow smoothly through the axial blood pump with satisfactory hydraulics performance and without separation flow.
The evaluation of blood compatibility of biomaterials is crucial for ensuring the clinical safety of implantable medical devices. To address the limitations of traditional testing methods in real-time monitoring and electrical property analysis, this study developed a portable electrical impedance tomography (EIT) system. The system uses a 16-electrode design, operates within a frequency range of 1 to 500 kHz, achieves a signal to noise ratio (SNR) of 69.54 dB at 50 kHz, and has a data collection speed of 20 frames per second. Experimental results show that the EIT system developed in this study is highly consistent with a microplate reader (R2=0.97) in detecting the hemolytic behavior of industrial-grade titanium (TA3) and titanium alloy—titanium 6 aluminum 4 vanadium (TC4) in anticoagulated bovine blood. Additionally, with the support of a multimodal image fusion Gauss-Newton one-step iterative algorithm, the system can accurately locate and monitor in real-time the dynamic changes in blood permeation and coagulation caused by TC4 in vivo. In conclusion, the EIT system developed in this study provides a new and effective method for evaluating the blood compatibility of biomaterials.
Abstract： Objective To summarize the clinical experiences of performing extracorporeal membrane oxygenation (ECMO) on patients with heart and respiratory failure, and compare the clinical outcomes of Medtronic system and Quadrox PLS system. Methods We retrospectively analyzed the clinical data of 121 heart and respiratory failure patients who underwent ECMO treatment in Fu Wai Hospital from December 2004 to December 2009. Based on the different systems used, 121 patients were divided into two groups. In group M, there were 65 patients including 41 males and 24 females, with an age of 26.6±25.9 years; and they accepted Medtronic ECMO system treatment. In group Q, there were 56 patients including 39 males and 17 females, with an age of 32.4±23.9 years and they underwent Quadrox PLS ECMO system treatment. The evaluation of the clinical outcomes of these two different systems was based on the comparison of transmembrane pressure drop (TMPD), anticoagulation, hemolysis, plasma leakage, organ function, complication and hospital mortality between the two groups. Results Compared with group M, ECMO with Quadrox PLS system was associated with lower TMPD (at the beginning of ECMO: 15.0±6.0 mm Hg vs.28.0±5.0 mm Hg, P=0.000; 24 hours later: 16.0±5.0 mm Hg vs. 30.0±7.0 mm Hg, P=0.000) and less thrombus formation(7.1% vs.23.1%, P=0.037), less plasma leakage (0.0% vs. 50.8%, P=0.000), less hemolysis (14.3% vs. 29.2%, P=0.047). There were no significant differences between the two groups in support duration, complication rate, and hospital mortality(Pgt;0.05). Conclusion Both devices have similar effects for safe clinical application, but Quadrox PLS ECMO system has a relatively high biocompatibility with lower TMPD, less plasma leakage, and thrombus formation.
ObjectiveTo investigate the effect of inhibiting autotaxin (ATX)-lysophosphatidic acid (LPA) pathway on the cartilage of knee osteoarthritis in rats.MethodsPrimary chondrocytes within three generations of Sprague-Dawley rats (8 weeks old, male) were randomly divided into 6 groups, including blank control group, model group, 1 μmol/L PF-8380 group, 10 μmol/L PF-8380 group, 1 μmol/L Ki16425 group, and 10 μmol/L Ki16425 group. Except for the blank control group, the other groups were modeled with osteoarthritis using interleukin-1β (10 ng/mL, 24 h), and then the experimental groups, i.e., 1 μmol/L PF-8380 group, 10 μmol/L PF-8380 group, 1 μmol/L Ki16425 group, and 10 μmol/L Ki16425 group, were intervened with 1, 10 μmol/L PF-8380 (ATX inhibitor) and 1, 10 μmol/L Ki16425 (LPA receptor antagonist) for 24 h, respectively. immunocytochemistry staining was used to determine the expression of type Ⅱ collagen (Col Ⅱ) in cytoplasm, and Western Blot was used to determine the expression of ATX, LPA, and matrix metalloproteinase-13 (MMP-13) in chondrocytes.ResultsCompared with the blank control group, the average absorbance of Col Ⅱ in chondrocytes in the model group was significantly reduced (0.003 9±0.000 8 vs. 0.110 0± 0.009 0, P<0.05). The expression levels of ATX, LPA, and MMP-13 in chondrocytes in the model group, 1 μmol/L PF-8380 group, 10 μmol/L PF-8380 group, and 1 μmol/L Ki16425 group were significantly higher than those in the blank control group, while the expression levels of ATX, LPA, and MMP-13 in the 10 μmol/L Ki16425 group had no significant difference with those in the blank control group; the expression levels of ATX, LPA, and MMP-13 in the model group, 10 μmol/L PF-8380 group, and 1 μmol/L PF-8380 group decreased in order; the expression levels of ATX, LPA, and MMP-13 in the model group, 1 μmol/L Ki16425 group, and 10 μmol/L Ki16425 group decreased in order.ConclusionInhibiting ATX-LPA pathway may inhibit the up-regulation of MMP-13 levels in articular cartilage of osteoarthritis in rats to reduce the damage of cartilage.
