Sevela K, Gajdůsková V
II. vnitrní klinika LF MU a FN U sv. Anny, Brno.
Vnitr Lek. 1996 Jun;42(6):408-13.
The formation of thrombi in the haemoperfusion column is undesirable as it deprives the patient of blood elements and reduces the eliminating capacity of the haemoperfusion column. This applies in particular to patients with acute intoxications treated by haemoperfusion. In experimental haemoperfusions in animals the authors provided evidence of a close correlation between thrombus formation in the haemoperfusion column and the number of stops of the blood flow in the course of individual experimental haemoperfusions. The period of stops was always 1.5 min. A further even closer correlation was found only between the formation of thrombi in the haemoperfusion column and the products of the number of stops of the blood flow (and the total period of arrests of the blood flow resp.) and the pressure gradient on the blood pump (difference of actual pressure readings before and beyond the blood pump). This gradient differed in every haemoperfusion but was constant during operation. It was induced and maintained by means of mechanical keys on the tube of the suction set. The objective of the work was to evaluate the influence of blood pressures in the area of the blood pump on the process of blood clotting in the haemoperfusion column. The blood flow, another factor influencing the intensity of blood clotting in the haemoperfusion column, was therefore the same in all experiments and constant in the course of their implementation. The extent of thrombus formation was evaluated after completed haemoperfusion and destruction of the cover of the haemoperfusion column by quantitative assessment of protein nitrogen referred to the weight of the adsorbent. The authors maintain that poor suction of blood, which precedes in clinical practice forced arrest of the circulation promotes the process of thrombus formation in the haemoperfusion column.
血液灌流柱中形成血栓是不理想的，因为这会使患者失去血液成分，并降低血液灌流柱的清除能力。这尤其适用于通过血液灌流治疗的急性中毒患者。在动物实验性血液灌流中，作者提供了证据表明血液灌流柱中血栓形成与个体实验性血液灌流过程中血流停止次数之间存在密切相关性。停止时间始终为1.5分钟。仅在血液灌流柱中血栓形成与血流停止次数（以及血流阻断的总时间）的乘积和血泵上的压力梯度（血泵前后实际压力读数之差）之间发现了更紧密的相关性。这种梯度在每次血液灌流中都不同，但在操作过程中是恒定的。它是通过抽吸装置管路上的机械键来诱导和维持的。这项工作的目的是评估血泵区域的血压对血液灌流柱中血液凝固过程的影响。因此，在所有实验中，影响血液灌流柱中血液凝固强度的另一个因素——血流是相同的，并且在实验实施过程中是恒定的。在完成血液灌流并破坏血液灌流柱的覆盖物后，通过对吸附剂重量中蛋白质氮的定量评估来评估血栓形成的程度。作者认为，在临床实践中导致循环被迫停止之前的血液抽吸不良会促进血液灌流柱中血栓形成的过程。
