Gourlay Terence, Simpson C, Robertson C A
Biomedical Engineering, University of Strathclyde, Glasgow, UK.
J R Army Med Corps. 2018 May;164(2):96-102. doi: 10.1136/jramc-2017-000789. Epub 2017 Oct 26.
Uncontrolled haemorrhage is the leading cause of death on the battlefield, and two-thirds of these deaths result from non-compressible haemorrhage. Blood salvage and autotransfusion represent an alternative to conventional blood transfusion techniques for austere environments, potentially providing blood to the casualty at point of injury. The aim of this paper is to describe the design, development and initial proof-of-concept testing of a portable blood salvage and autotransfusion technology to enhance survivability of personnel requiring major medical interventions in austere or military environments.
A manually operable, dual-headed pump was developed that removes blood from site of injury to a collection reservoir (upper pump) and back to casualty (lower pump). Theoretical flow rate calculations determined pump configuration and a three-dimensionally printed peristaltic pump was manufactured. Flow rates were tested with fresh bovine blood under laboratory conditions representative of the predicted clinical environment.
Mathematical modelling suggested flow rates of 3.6 L/min and 0.57 L/min for upper and lower pumps. Using fresh bovine blood, flow rates produced were 2.67 L/min and 0.43 L/min. To mimic expected battlefield conditions, upper suction pump flow rate was calculated using a blood/air mixture.
The authors believe that this technology can potentially enhance survivability for casualties in austere and deployed military settings through autotransfusion and cell concentration. It reduces negative effects of blood donation on the conventional donor pool, and potentially negates the logistical constraints associated with allogenic transfusions.
出血失控是战场上的主要死因,其中三分之二的死亡是由不可压缩性出血导致的。血液回收与自体输血是在严峻环境下替代传统输血技术的一种选择,有可能在受伤现场为伤员提供血液。本文旨在描述一种便携式血液回收与自体输血技术的设计、开发及初步概念验证测试,以提高在严峻或军事环境中需要进行重大医疗干预的人员的生存能力。
研发了一种手动操作的双头泵,该泵将血液从受伤部位抽出至收集容器(上泵),然后再输回伤员体内(下泵)。通过理论流速计算确定泵的配置,并制造了一个三维打印的蠕动泵。在代表预期临床环境的实验室条件下,用新鲜牛血对流速进行了测试。
数学模型表明上泵和下泵的流速分别为3.6升/分钟和0.57升/分钟。使用新鲜牛血时,产生的流速分别为2.67升/分钟和0.43升/分钟。为模拟预期的战场条件,使用血液/空气混合物计算上吸泵的流速。
作者认为,这项技术通过自体输血和细胞浓缩,有可能提高严峻和部署军事环境中伤员的生存能力。它减少了献血对传统供血库的负面影响,并有可能消除与异体输血相关的后勤限制。