Lahmann John M, Faase Ryan A, Leu Hsuan Yu, Jacques Steven L, Scottoline Brian, Schilke Kate F, Baio Joe E, Higgins Adam Z
School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, Oregon 97331, USA.
Department of Bioengineering, University of Washington, Seattle, Washington 98105, USA.
Biomicrofluidics. 2021 Nov 24;15(6):064104. doi: 10.1063/5.0066073. eCollection 2021 Dec.
While in most cases, jaundice can be effectively treated using phototherapy, severe cases require exchange transfusion, a relatively risky procedure in which the neonate's bilirubin-rich blood is replaced with donor blood. Here, we examine extracorporeal blood treatment in a microfluidic photoreactor as an alternative to exchange transfusion. This new treatment approach relies on the same principle as phototherapy but leverages microfluidics to speed up bilirubin removal. Our results demonstrate that high-intensity light at 470 nm can be used to rapidly reduce bilirubin levels without causing appreciable damage to DNA in blood cells. Light at 470 nm was more effective than light at 505 nm. Studies in Gunn rats show that photoreactor treatment for 4 h significantly reduces bilirubin levels, similar to the bilirubin reduction observed for exchange transfusion and on a similar time scale. Predictions for human neonates demonstrate that this new treatment approach is expected to exceed the performance of exchange transfusion using a low blood flow rate and priming volume, which will facilitate vascular access and improve safety.
在大多数情况下,黄疸可以通过光疗得到有效治疗,但严重病例需要进行换血疗法,这是一种相对危险的程序,即使用供血者的血液替换新生儿富含胆红素的血液。在此,我们研究了微流控光反应器中的体外血液治疗作为换血疗法的替代方法。这种新的治疗方法与光疗基于相同的原理,但利用微流控技术加快胆红素的清除。我们的结果表明,470纳米的高强度光可用于快速降低胆红素水平,而不会对血细胞中的DNA造成明显损伤。470纳米的光比505纳米的光更有效。对冈恩大鼠的研究表明,光反应器治疗4小时可显著降低胆红素水平,类似于换血疗法在相似时间范围内观察到的胆红素降低情况。对人类新生儿的预测表明,这种新的治疗方法预计在低血流速率和预充量的情况下将超过换血疗法的性能,这将便于血管通路并提高安全性。