ASAIO transactions / American Society for Artificial Internal Organs
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To avoid the drawbacks of systemic anticoagulation during prolonged extracorporeal lung assist, a heparinization technique has been developed by which partially degraded heparin is covalently end-point attached to the surface of the equipment that constitutes the extracorporeal circuit (Carmeda Bio-Active Surface; CABS). Four patients have been treated with extracorporeal carbon dioxide elimination and low pressure-low frequency ventilation for acute respiratory failure (ARF) by means of extracorporeal equipment coated with the CBAS. The author's experience is that by using the CBAS technique it is possible to perform an extracorporeal circulation on a prolonged basis with minimal systemically administered heparin, thus avoiding the risk of major coagulation defects.
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Comparative Study
In vitro evaluation of a pyridoxalated hemoglobin polyoxyethylene conjugate in reversing cell sickling.
In sickle cell disease (SCD) microcirculatory blockage by red blood cells (RBC) occurs because of their low oxygen concentration, which results in both sickling and painful crises. Pyridoxalated hemoglobin polyoxyethylene (PHP), developed from human RBC hemoglobin (Hb) by chemical modification as an oxygen carrier, was evaluated in vitro for its ability to reverse cell sickling. PHP solutions of 6 or 8 g % Hb and a P50 of 20 mmHg were evaluated. ⋯ A novel artificial capillary system (ACS) modeling the dynamics of the microcirculation of the body was used. With the ACS plugged with deoxygenated cells, perfusion with oxygenated cell-PHP solutions was significantly more efficient in reversing the blockage than oxygenated saline and Hespan solutions. PHP reverses cell sickling by its effective delivery of oxygen.