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不同中心静脉导管对红细胞损伤与血液相容性的评价。

An Evaluation of the Red Cell Damage and Hemocompatibility of Different Central Venous Catheters.

机构信息

Institute of Microbiology and Immunology, Medical Faculty of Ljubljana, University of Ljubljana, Ljubljana, Slovenia.

Department of Pediatric Surgery and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Biomed Res Int. 2020 Apr 14;2020:8750150. doi: 10.1155/2020/8750150. eCollection 2020.

Abstract

BACKGROUND

The aim of our study was to evaluate the damaging impact of characteristics of the central venous catheters (CVCs) on red blood cells.

METHODS

CVCs from three different manufacturers were analyzed, including the presence of coating, tunnel geometry, length, lumen diameter, and number of lumens with two respective flow rates (33 mL/min and 500 mL/min). Blood cell damage was defined by analyzing microparticle (MP) and hematologic analysis. MPs were isolated by ultracentrifugation of erythrocyte concentrate and analyzed on a flow cytometer.

RESULTS

Characteristics of catheters were not associated with blood cell damage at a low flow rate but showed an effect with a high flow rate. CVCs with a polyhexanide methacrylate coating have caused statistically less blood cell damage than noncoated CVCs. The length of lumens, diameter, and geometry of the tunnel showed no differences in blood cell damage. Meanwhile, the number of lumens was predicted to have a greater effect on the erythrocyte damage, which was revealed with the formation of MPs and hematological parameters. CVCs with five lumens caused significantly less damage to the blood cells than CVCs with a single lumen. Moreover, a high flow rate of 500 mL/min caused less damage to the blood cells than a low rate of 33 mL/min.

CONCLUSION

Properties of CVCs are an important factor for quality patient care, especially when transfusing blood with high flow rates, as we want to provide a patient with high-quality blood with as few damaged cells as possible.

摘要

背景

我们研究的目的是评估中心静脉导管(CVC)的特性对红细胞的损伤作用。

方法

分析了来自三个不同制造商的 CVC,包括涂层的存在、隧道几何形状、长度、管腔直径以及两个各自流速(33 毫升/分钟和 500 毫升/分钟)的内腔数量。通过分析微颗粒(MP)和血液分析来定义血细胞损伤。通过对红细胞浓缩物进行超速离心分离 MPs,并在流式细胞仪上进行分析。

结果

导管的特性与低流速下的血细胞损伤无关,但在高流速下显示出影响。与未涂层的 CVC 相比,具有聚己内酰胺甲基丙烯酸酯涂层的 CVC 引起的血细胞损伤统计学上更少。内腔的长度、直径和隧道的几何形状在血细胞损伤方面没有差异。同时,内腔数量被预测对红细胞损伤有更大的影响,这是通过 MPs 的形成和血液学参数揭示的。与单内腔 CVC 相比,五内腔 CVC 对血细胞的损伤明显更小。此外,高流速 500 毫升/分钟比低流速 33 毫升/分钟对血液细胞的损伤更小。

结论

CVC 的特性是患者护理质量的重要因素,特别是在高流速输血时,因为我们希望为患者提供尽可能少受损细胞的高质量血液。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c47/7178527/73c9c5f70d2a/BMRI2020-8750150.001.jpg

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