Meinhardt Jürgen P, Annich Gail M, Miskulin Judiann, Kawai Toshinori, Ashton Brian A, Bartlett Robert H
Institut fur Anasthesiologie und Operative Intensivmedizin, Universitatsklinikum Mannheim, Theodur-Kutzer-Ufer, Mannheim, Germany.
ASAIO J. 2003 Jul-Aug;49(4):395-400.
In an effort to better mimic the thromboresistive nature of vascular endothelium, extracorporeal circuits bonded with heparin or phospholipids were developed. Using no systemic heparinization, these circuits were compared with standard poly(vinyl)chloride (PVC) (Tygon) in a rabbit model of extracorporeal circulation (ECC). Control circuits were run with and without systemic heparinization and used as comparison groups against the test circuits. Two New Zealand White rabbits were used per study: One was used as the platelet donor for 111Indium platelet labeling; the other animal was placed on bicaval ECC for 4 hours. Circuits (heparin coated n = 6, phospholipid coated n = 8, nonheparinized controls n = 14, heparinized controls n = 18) consisted of 1 m of tubing, two downsizing connectors, and two venous cannulae. ECC blood flow was at least 75 ml/min. Platelet and fibrinogen measurements were made hourly, and circuit dosimetry was performed at the end of the study or on circuit thrombosis. Thrombosis of the circuit occurred in one heparin coated, two phospholipid coated, and eight nonheparinized control circuits. None of the heparinized control circuits thrombosed. There was no significant difference between the groups with regard to platelet count or platelet adhesion. Test circuits exhibited preservation of fibrinogen levels. In this rabbit model of ECC, circuits coated with heparin or phospholipids appeared to preserve fibrinogen levels but did not reduce platelet adhesion or consumption.
为了更好地模拟血管内皮的抗血栓特性,人们开发了与肝素或磷脂结合的体外循环回路。在兔体外循环(ECC)模型中,这些回路不使用全身肝素化,与标准聚氯乙烯(PVC)(泰贡)回路进行比较。对照回路在有和没有全身肝素化的情况下运行,并用作测试回路的比较组。每项研究使用两只新西兰白兔:一只作为111铟血小板标记的血小板供体;另一只动物进行双腔ECC 4小时。回路(肝素涂层n = 6,磷脂涂层n = 8,非肝素化对照n = 14,肝素化对照n = 18)由1米长的管道、两个缩径连接器和两个静脉插管组成。ECC血流量至少为75毫升/分钟。每小时进行血小板和纤维蛋白原测量,并在研究结束时或回路血栓形成时进行回路剂量测定。回路血栓形成发生在一个肝素涂层回路、两个磷脂涂层回路和八个非肝素化对照回路中。肝素化对照回路均未发生血栓形成。各组之间在血小板计数或血小板黏附方面没有显著差异。测试回路显示纤维蛋白原水平得以保留。在这个兔ECC模型中,涂有肝素或磷脂的回路似乎保留了纤维蛋白原水平,但没有减少血小板黏附或消耗。