通过比瓦利鲁丁和二碳酸盐增强血液兼容性,作为尿管式轴流系统中肝素的替代品
Kaitlyn R Ammann1, Christine E Outridge1, Tiana Silver1
1Arizona Center for Accelerated Biomedical Innovation, Sarver Heart Center, University of Arizona Health Sciences, The University of Arizona, Tucson, Arizona, USA.
概括
这项研究探讨了在Impella净化溶液中使用比瓦利鲁丁而不是系统性肝素和二碳酸. 一种无氨酸的方法显示出更好的血液兼容性,减少血液溶解和保持血小板活性.
科学领域:
- 心血管医学 心血管医学
- 生物材料科学 生物材料科学
- 血液学 血液学 血液学
背景情况:
- 由于血栓形成的风险,心血管治疗设备往往需要全身肝素化.
- 伊佩拉轴流系统需要使用氨酸或碳酸净化溶液进行内部 perfusion.
- 当前使用氨酸可以导致可变的抗凝血,增加出血风险和氨酸敏感性并发症.
研究的目的:
- 为了研究比瓦利鲁丁作为全身肝素的替代品.
- 为了评估二碳酸作为一种替代局部装置氨酸在清洗溶液中的替代品.
- 评估无肝素的Impella系统的可行性,以简化抗凝管理.
主要方法:
- 在模拟循环系统中使用猪血评估血相容性.
- 在Impella 5.5装置运行了4小时,使用了氨酸或比瓦利鲁丁抗凝剂.
- 清洗溶液含有肝素或碳酸,并进行血溶,血小板激活和vWF降解的连续血液分析.
主要成果:
- 比瓦利鲁丁和二氧化碳酸的组合表明与肝素相比,可比或增强的血红相容性.
- 观察到血液溶解的平均显著下降 (40±20.8 mg/dL).
- 血小板活性保持,P-选择因暴露的平均增加为8.0 ± 5.6%.
结论:
- 这些发现支持Impella系统的潜在无肝素策略.
- 这种方法可以简化抗凝固管理.
- 降低出血风险和与肝素相关的并发症是潜在的好处.
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