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Dialysis nanocomposite membranes based on carbon nanoforms inhibiting blood plasma protein adsorption. 基于碳纳米形式的透析纳米复合膜可抑制血浆蛋白吸附。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-08-22 DOI: 10.1177/03913988241269440
Dominika Wójtowicz, Roksana Kurpanik, Dominika Nguyen Ngoc, Joanna Wessley-Szponder, Ewa Stodolak-Zych

Background: Protein adsorption on medical devices in contact with blood is a significant issue during renal replacement therapy. Main forces determining fouling are the electrostatic interactions between membrane and charged protein, but the dialysis membrane surface charges can be adjusted by modifying the polymer matrix to decrease the blood plasma protein adsorption.

Methods: In this study, polysulfone membranes (PSU) were modified by incorporation of carbon nanoparticles such as: multiwall carbon nanotubes (2 wt.% MWCNT), graphene oxide (1 wt.% GO), and graphite (5 wt.% GR) during manufacturing process (nonsolvent-induced phase separation, NIPS). The PSU flat sheet membrane was the reference sample.

Results: Observed morphology of nanocomposite membranes was similar (SEM imaging); all of them had finger-like pore structure with unimodal distribution of pore size and similar skin-to-support ratio (1:3). The carbon nanoadditives also influenced the surface wettability: hydrophobicity and surface free energy of membranes increased (polar components of energy were reduced, while the dispersive components were increased).

Conclusion: The surface charge of nanocomposite membranes increased, when the polymer matrix has been modified with CNT or GR. This significantly affects the adsorption of proteins such as chicken (CSA) and bovine serum albumin (BSA) and reduces blood clotting on the membrane.

背景:蛋白质吸附在与血液接触的医疗设备上是肾脏替代治疗过程中的一个重要问题。决定污垢产生的主要因素是膜与带电蛋白质之间的静电相互作用,但透析膜表面的电荷可通过改性聚合物基质来调整,以减少血浆蛋白质的吸附:本研究在聚砜膜(PSU)的制造过程中加入了碳纳米颗粒,如:多壁碳纳米管(2 wt.% MWCNT)、氧化石墨烯(1 wt.% GO)和石墨(5 wt.% GR)(非溶剂诱导相分离,NIPS)。PSU 平板膜为参考样品:观察到的纳米复合膜形态相似(扫描电子显微镜成像);所有纳米复合膜都具有指状孔隙结构,孔隙大小呈单峰分布,表皮与支撑物的比例相似(1:3)。碳纳米添加剂还影响了表面润湿性:膜的疏水性和表面自由能增加(能量的极性成分减少,而分散成分增加):结论:用 CNT 或 GR 对聚合物基质进行改性后,纳米复合膜的表面电荷增加。结论:用 CNT 或 GR 对聚合物基质进行改性后,纳米复合膜的表面电荷增加,这极大地影响了膜对鸡肉(CSA)和牛血清白蛋白(BSA)等蛋白质的吸附,并减少了膜上的血液凝结。
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引用次数: 0
Graphene-enhanced PCL electrospun nanofiber scaffolds for cardiac tissue engineering. 用于心脏组织工程的石墨烯增强 PCL 电纺纳米纤维支架。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-08-08 DOI: 10.1177/03913988241266088
Ana M Muñoz-Gonzalez, Sara Leal-Marin, Dianney Clavijo-Grimaldo, Birgit Glasmacher

Cardiovascular diseases, particularly myocardial infarction, have significant healthcare challenges due to the limited regenerative capacity of injured heart tissue. Cardiac tissue engineering (CTE) offers a promising approach to repairing myocardial damage using biomaterials that mimic the heart's extracellular matrix. This study investigates the potential of graphene nanopowder (Gnp)-enhanced polycaprolactone (PCL) scaffolds fabricated via electrospinning to improve the properties necessary for effective cardiac repair. This work aimed to analyze scaffolds with varying graphene concentrations (0.5%, 1%, 1.5%, and 2% by weight) to determine their morphological, chemical, mechanical, and biocompatibility characteristics. The results presented that incorporating graphene improves PCL scaffolds' mechanical properties and cellular interactions. The optimal concentration of 1% graphene significantly enhanced mechanical properties and biocompatibility, promoting cell adhesion and proliferation. These findings suggest that Gnp-enhanced PCL scaffolds at this concentration can serve as a potent substrate for CTE providing insights into designing more effective biomaterials for myocardial restoration.

由于受伤心脏组织的再生能力有限,心血管疾病,尤其是心肌梗塞,给医疗保健带来了巨大挑战。心脏组织工程(CTE)为使用模拟心脏细胞外基质的生物材料修复心肌损伤提供了一种前景广阔的方法。本研究调查了通过电纺丝制造的石墨烯纳米粉体(Gnp)增强聚己内酯(PCL)支架的潜力,以改善有效心脏修复所需的性能。这项研究旨在分析不同石墨烯浓度(0.5%、1%、1.5% 和 2%(重量百分比))的支架,以确定其形态、化学、机械和生物相容性特征。结果表明,加入石墨烯可改善 PCL 支架的机械性能和细胞相互作用。最佳浓度为 1%的石墨烯可显著提高机械性能和生物相容性,促进细胞粘附和增殖。这些研究结果表明,该浓度的 Gnp 增强 PCL 支架可作为 CTE 的有效基质,为设计更有效的心肌修复生物材料提供了启示。
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引用次数: 0
Influence of titanium surface roughness on a nanoscale on the zeta potential and platelet adhesion. 纳米级钛表面粗糙度对 zeta 电位和血小板附着力的影响
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI: 10.1177/03913988241268000
Isabell Esslinger, Michael Lommel, Florian Kießlich, Ulrich Kertzscher, Tim Bierewirtz

Thromboembolic complications still arise on blood contacting surfaces. Surface charge and topography influence the subsequent deposition of proteins and platelets, potentially leading to thrombi. Research showed a correlation of surface charge and nanoscale roughness, and a negative surface charge as well as a smooth surface finish are associated with lower thrombogenicity. The aim of this study was to compare the platelet adhesion on titanium with different nanoscale roughnesses and to examine if those roughness variations caused a change in surface charge. Titanium samples were polished and roughened to four different nanoscale roughness levels. Platelet adhesion (covered surface area (CSA), N = 8) was tested in flow chambers with human whole blood using fluorescence imaging. ζ-potential was measured over a broad range of pH-values and interpolated to obtain the ζ-potential for pHBlood (7.4). Platelet adhesion tests were evaluated in terms of p-values and the Wilcoxon test effect size and the trend of the ζ-potential at pHBlood and the CSA was compared. Ra-values ranged between 35 (polished) and 156 nm. Regarding platelet adhesion, the polished sample showed the lowest mean CSA with a medium or strong effect size compared to the roughened samples. The interpolated ζ-potentials for pHBlood follow a similar trend as the CSA, with the lowest ζ-potential measured for the polished surface. These findings suggest that the decreasing ζ-potential due to lower nanoscale roughness might be an additional explanation for the improved hemocompatibility besides the smoother topography.

血栓栓塞并发症仍然发生在血液接触表面。表面电荷和形貌会影响蛋白质和血小板的后续沉积,从而可能导致血栓。研究表明,表面电荷与纳米级粗糙度相关,负表面电荷和光滑表面与较低的血栓形成相关。本研究的目的是比较血小板在具有不同纳米级粗糙度的钛上的附着情况,并研究这些粗糙度的变化是否会导致表面电荷的变化。钛样品经过抛光和粗化处理,达到四种不同的纳米级粗糙度水平。使用荧光成像技术在装有人体全血的流动室中测试血小板附着力(覆盖表面积,N = 8)。在广泛的 pH 值范围内测量了ζ电位,并通过内插法获得了 pHBlood(7.4)的ζ电位。血小板粘附试验以 p 值和 Wilcoxon 检验效应大小进行评估,并比较了 pHBlood 和 CSA 的ζ电位趋势。Ra 值介于 35(抛光)和 156 nm 之间。在血小板附着力方面,与粗糙样品相比,抛光样品的平均 CSA 最低,效应大小为中等或强。pHBlood 的内插ζ电位与 CSA 的趋势相似,抛光表面的ζ电位最低。这些发现表明,除了更光滑的表面形貌外,纳米级粗糙度降低导致的ζ电位下降可能是血液相容性改善的另一个原因。
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引用次数: 0
Effects of high-frequency mechanical stimuli on flow related vascular cell biology. 高频机械刺激对流动相关血管细胞生物学的影响。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI: 10.1177/03913988241268105
Elena Carrara, Luca Soliveri, Sofia Poloni, Michela Bozzetto, Chiara Emma Campiglio

Mechanical forces related to blood pressure and flow patterns play a crucial role in vascular homeostasis. Perturbations in vascular stresses and strain resulting from changes in hemodynamic may occur in pathological conditions, leading to vascular dysfunction as well as in vascular prosthesis, arteriovenous shunt for hemodialysis and in mechanical circulation support. Turbulent-like blood flows can induce high-frequency vibrations of the vessel wall, and this stimulus has recently gained attention as potential contributors to vascular pathologies, such as development of intimal hyperplasia in arteriovenous fistula for hemodialysis. However, the biological response of vascular cells to this stimulus remains incompletely understood. This review provides an analysis of the existing literature concerning the impact of high-frequency stimuli on vascular cell morphology, function, and gene expression. Morphological and functional investigations reveal that vascular cells stimulated at frequencies higher than the normal heart rate exhibit alterations in cell shape, alignment, and proliferation, potentially leading to vessel remodeling. Furthermore, vibrations modulate endothelial and smooth muscle cells gene expression, affecting pathways related to inflammation, oxidative stress, and muscle hypertrophy. Understanding the effects of high-frequency vibrations on vascular cells is essential for unraveling the mechanisms underlying vascular diseases and identifying potential therapeutic targets. Nevertheless, there are still gaps in our understanding of the molecular pathways governing these cellular responses. Further research is necessary to elucidate these mechanisms and their therapeutic implications for vascular diseases.

与血压和血流模式有关的机械力在血管平衡中起着至关重要的作用。在病理情况下,血流动力学变化会导致血管应力和应变紊乱,从而导致血管功能障碍,在血管假体、用于血液透析的动静脉分流和机械循环支持中也是如此。湍流状血流可引起血管壁的高频振动,这种刺激作为血管病变的潜在诱因,如血液透析动静脉瘘内膜增生的发展,最近已引起人们的关注。然而,血管细胞对这种刺激的生物反应仍不完全清楚。本综述分析了有关高频刺激对血管细胞形态、功能和基因表达影响的现有文献。形态学和功能学研究显示,血管细胞在高于正常心率的频率刺激下,细胞形状、排列和增殖会发生改变,从而可能导致血管重塑。此外,振动还能调节内皮细胞和平滑肌细胞的基因表达,影响与炎症、氧化应激和肌肉肥大有关的途径。了解高频振动对血管细胞的影响对于揭示血管疾病的内在机制和确定潜在的治疗靶点至关重要。然而,我们对支配这些细胞反应的分子途径的了解仍有差距。有必要开展进一步研究,以阐明这些机制及其对血管疾病的治疗意义。
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引用次数: 0
Assessment of haemolysis models for a positive-displacement total artificial heart. 评估正位移全人工心脏的溶血模型。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-09-19 DOI: 10.1177/03913988241267797
Joseph Bornoff, Shaikh Faisal Zaman, Azad Najar, Thomas Finocchiaro, Ina Laura Perkins, Andrew N Cookson, Katharine H Fraser

The assessment and reduction of haemolysis within mechanical circulatory support (MCS) remains a concern with regard to device safety and regulatory approval. Numerical methods for predicting haemolysis have typically been applied to rotary MCS devices and the extent to which these methods apply to positive-displacement MCS is unclear. The aim of this study was to evaluate the suitability of these methods for assessing haemolysis in positive-displacement blood pumps. Eulerian scalar-transport and Lagrangian particle-tracking approaches derived from the shear-based power-law relationship were used to calculate haemolysis in a computational fluid dynamics model of the Realheart total artificial heart. A range of power-law constants and their effect on simulated haemolysis were also investigated. Both Eulerian and Lagrangian methods identified the same key mechanism of haemolysis: leakage flow through the bileaflet valves. Whilst the magnitude of haemolysis varied with different power-law constants, the method of haemolysis generation remained consistent. The Eulerian method was more robust and reliable at identifying sites of haemolysis generation, as it was able to capture the persistent leakage flow throughout the entire pumping cycle. This study paves the way for different positive-displacement MCS devices to be compared across different operating conditions, enabling the optimisation of these pumps for improved patient outcomes.

机械循环支持(MCS)中溶血的评估和减少仍然是设备安全和监管审批方面的一个关注点。预测溶血的数值方法通常适用于旋转式 MCS 设备,而这些方法在多大程度上适用于正排量 MCS 尚不清楚。本研究旨在评估这些方法是否适用于评估正排量血泵的溶血情况。根据基于剪切力的幂律关系推导出的欧拉标量传输和拉格朗日粒子追踪方法被用来计算Realheart全人工心脏计算流体动力学模型中的溶血量。此外,还研究了一系列幂律常数及其对模拟溶血的影响。欧拉和拉格朗日方法都确定了相同的溶血关键机制:通过双叶瓣膜的泄漏流。虽然溶血量随不同的幂律常数而变化,但溶血产生的方法却保持一致。欧拉方法能够捕捉到整个泵血周期中持续存在的漏血流,因此在确定溶血发生部位方面更加稳健可靠。这项研究为在不同操作条件下比较不同的正排量 MCS 设备铺平了道路,从而可以优化这些泵,改善患者的治疗效果。
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引用次数: 0
Comparison of hydroxyapatite and honeycomb micro-structure in bone tissue engineering using electrospun beads-on-string fibers. 使用电纺串珠纤维的骨组织工程中羟基磷灰石和蜂窝状微结构的比较。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI: 10.1177/03913988241268033
Nicolas Rivoallan, Marc Mueller, Timothée Baudequin, Pascale Vigneron, Anne Hébraud, Rachid Jellali, Quentin Dermigny, Anne Le Goff, Guy Schlatter, Birgit Glasmacher, Cécile Legallais

Thick honeycomb-like electrospun scaffold with nanoparticles of hydroxyapatite (nHA) recently demonstrated its potential to promote proliferation and differentiation of a murine embryonic cell line (C3H10T1/2) to osteoblasts. In order to distinguish the respective effects of the structure and the composition on cell differentiation, beads-on-string fibers were used to manufacture thick honeycomb-like scaffolds without nHA. Mechanical and biological impacts of those beads-on string fibers were evaluated. Uniaxial tensile test showed that beads-on-string fibers decreased the Young Modulus and maximal stress but kept them appropriate for tissue engineering. C3H10T1/2 were seeded and cultured for 6 days on the scaffolds without any growth factors. Viability assays revealed the biocompatibility of the beads-on-string scaffolds, with adequate cells-materials interactions observed by confocal microscopy. Alkaline phosphatase staining was performed at day 6 in order to compare the early differentiation of cells to bone fate. The measure of stained area and intensity confirmed the beneficial effect of both honeycomb structure and nHA, independently. Finally, we showed that honeycomb-like electrospun scaffolds could be relevant candidates for promoting bone fate to cells in the absence of nHA. It offers an easier and faster manufacture process, in particular in bone-interface tissue engineering, permitting to avoid the dispersion of nHA and their interaction with the other cells.

含有羟基磷灰石纳米颗粒(nHA)的厚蜂窝状电纺支架最近被证明具有促进小鼠胚胎细胞系(C3H10T1/2)增殖和分化为成骨细胞的潜力。为了区分结构和成分各自对细胞分化的影响,我们使用串珠纤维制造了不含 nHA 的厚蜂窝状支架。对这些串珠纤维的机械和生物影响进行了评估。单轴拉伸测试表明,串珠纤维降低了杨氏模量和最大应力,但仍适用于组织工程。在不使用任何生长因子的情况下,将 C3H10T1/2 种子接种到支架上并培养 6 天。活力测定显示了珠串支架的生物相容性,共聚焦显微镜观察到了充分的细胞-材料相互作用。第 6 天进行了碱性磷酸酶染色,以比较细胞向骨命运的早期分化。染色面积和强度的测量结果证实,蜂窝结构和 nHA 都能产生有益的影响。最后,我们发现蜂窝状电纺支架可以在没有 nHA 的情况下促进细胞的骨命运。它提供了一种更简单、更快速的制造工艺,特别是在骨界面组织工程中,可以避免 nHA 的分散及其与其他细胞的相互作用。
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引用次数: 0
Purified granulocytes in extracorporeal cell therapy: A multifaceted approach to combat sepsis-induced immunoparalysis. 体外细胞疗法中的纯化粒细胞:抗脓毒症诱导的免疫麻痹的多重方法。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI: 10.1177/03913988241262901
Gerd Klinkmann, Sophie Brabandt, Marlene Möller, Thomas Wild, Benjamin Heskamp, Jens-Christian Schewe, Martin Sauer, Jens Altrichter, Steffen Mitzner

Background: Immune cell dysfunction plays a central role in sepsis-induced immunoparalysis. Targeted treatment using healthy donor immune cell transfusions, particularly granulocyte concentrates (GC) potentially induces tissue damage. Initial trials using GC in an extracorporeal immune cell perfusion system provided evidence for beneficial effects with fewer side effects, by separating patient and donor immune cell compartments. A multicenter clinical trial is exploring feasibility and effects of a 6-h treatment (NCT06143137). This ex vivo study examines technical feasibility and cellular effects of an extended treatment interval up to 24 h.

Methods: Standard GC were purified to increase the potential storage time and subsequently implemented in the extracorporeal immune cell perfusion system. Parameters assessed included cell viability, phagocytosis activity, oxidative burst, cytokine release, and metabolic parameters of purified. GC during an extended circulation time of up to 24 h.

Results: After storage of 72 h granulocytes were viable throughout the study period and exhibited preserved functionality and metabolic activity. The findings highlight a time-dependent nature of cytokine release by neutrophils in the extracorporeal circuit, as cytokine secretion patterns showed IL-8 peaking within 6 h, while MCP-1, IL-6, IL-1β, and TNF-α increased after 24 h of circulation.

Conclusion: Purified GC remain functional after 72 h of storage and additional 24 h in the circulating treatment model. Cytokine secretion patterns revealed a significant increase, especially between 10 and 24 h of treatment. Extending treatment time holds promise for enhancing immune response against sepsis-induced immunoparalysis. These findings provide valuable insights for optimizing immune-targeted therapeutic interventions.

背景:免疫细胞功能障碍在败血症诱发的免疫麻痹中起着核心作用。使用健康供体免疫细胞输注,特别是粒细胞浓缩物(GC)进行针对性治疗可能会诱发组织损伤。在体外免疫细胞灌注系统中使用粒细胞浓缩物的初步试验证明,通过分离患者和供体免疫细胞区,可产生较少副作用的有益效果。一项多中心临床试验正在探索 6 小时治疗的可行性和效果(NCT06143137)。这项体内外研究探讨了延长治疗间隔至 24 小时的技术可行性和细胞效应:方法:对标准 GC 进行纯化,以延长其潜在储存时间,随后将其应用于体外免疫细胞灌注系统。评估参数包括纯化 GC 的细胞活力、吞噬活性、氧化爆发、细胞因子释放和代谢参数。结果:结果:储存 72 小时后,粒细胞在整个研究期间都能存活,并表现出功能性和代谢活性。研究结果凸显了体外循环中中性粒细胞释放细胞因子的时间依赖性,细胞因子分泌模式显示 IL-8 在 6 小时内达到峰值,而 MCP-1、IL-6、IL-1β 和 TNF-α 则在循环 24 小时后增加:结论:在循环治疗模型中,纯化的 GC 在储存 72 小时和 24 小时后仍能发挥作用。细胞因子的分泌模式显示出显著的增加,尤其是在治疗的 10 到 24 小时之间。延长治疗时间有望增强对败血症引起的免疫麻痹的免疫反应。这些发现为优化免疫靶向治疗干预提供了宝贵的见解。
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引用次数: 0
Dynamic VAD simulations: Performing accurate simulations of ventricular assist devices in interaction with the cardiovascular system. 动态 VAD 模拟:对与心血管系统相互作用的心室辅助装置进行精确模拟。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-01 Epub Date: 2024-09-05 DOI: 10.1177/03913988241268067
Vincenz Crone, Mario Hahne, Finn Knüppel, Frank-Hendrik Wurm, Benjamin Torner

Medical advancements, particularly in ventricular assist devices (VADs), have notably advanced heart failure (HF) treatment, improving patient outcomes. However, challenges such as adverse events (strokes, bleeding and thrombosis) persist. Computational fluid dynamics (CFD) simulations are instrumental in understanding VAD flow dynamics and the associated flow-induced adverse events resulting from non-physiological flow conditions in the VAD.This study aims to validate critical CFD simulation parameters for accurate VAD simulations interacting with the cardiovascular system, building upon the groundwork laid by Hahne et al. A bidirectional coupling technique was used to model dynamic (pulsatile) flow conditions of the VAD CFD interacting with the cardiovascular system. Mesh size, time steps and simulation method (URANS, LES) were systematically varied to evaluate their impact on the dynamic pump performance (dynamic H-Q curve) of the HeartMate 3, aiming to find the optimal simulation configuration for accurately reproduce the dynamic H-Q curve. The new Overlapping Ratio (OR) method was developed and applied to quantify dynamic H-Q curves.In particular, mesh and time step sizes were found to have the greatest influence on the calculated pump performance. Therefore, small time steps and large mesh sizes are recommended to obtain accurate dynamic H-Q curves. On the other hand, the influence of the simulation method was not significant in this study. This study contributes to advancing VAD simulations, ultimately enhancing clinical efficacy and patient outcomes.

医学的进步,尤其是心室辅助装置(VAD)的进步,显著推进了心力衰竭(HF)的治疗,改善了患者的预后。然而,不良事件(中风、出血和血栓)等挑战依然存在。计算流体动力学(CFD)模拟有助于了解 VAD 的流动动力学以及 VAD 中非生理流动条件导致的相关流动诱发不良事件。本研究旨在 Hahne 等人奠定的基础上,验证关键 CFD 模拟参数,以准确模拟与心血管系统相互作用的 VAD。系统地改变了网格大小、时间步长和模拟方法(URANS、LES),以评估它们对 HeartMate 3 动态泵性能(动态 H-Q 曲线)的影响,目的是找到精确再现动态 H-Q 曲线的最佳模拟配置。开发并应用了新的重叠率(OR)方法来量化动态 H-Q 曲线。因此,建议采用小时间步长和大网格尺寸来获得精确的动态 H-Q 曲线。另一方面,本研究中模拟方法的影响并不显著。这项研究有助于推进 VAD 模拟,最终提高临床疗效和患者预后。
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引用次数: 0
ESAO-IFAO Congress. ESAO-IFAO大会。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-01 DOI: 10.1177/03913988241279540
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引用次数: 0
Clinical effect of regional citrate anticoagulation continuous renal replacement therapy in three patients with hypercalcemic crisis. 三名高钙血症危象患者接受区域性枸橼酸抗凝持续肾脏替代疗法的临床效果。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-06-01 Epub Date: 2024-06-13 DOI: 10.1177/03913988241259963
Chunyan Wang, Shilong Xiang

In this study, we investigated the effectiveness of regional citrate anticoagulation continuous renal replacement therapy (RCA-CRRT) in reducing blood calcium levels in three patients with hypercalcemia crisis caused by different etiologies. The sodium citrate chelation of calcium ions was utilized as an anticoagulant for treating severely affected patients. By adjusting the citrate anticoagulant dose and monitoring treatment indicators, RCA-CRRT parameters were actively modified to alleviate the hypercalcemia crisis and provide time for surgery or specialized treatment. Two patients experienced rapid and effective reductions in blood calcium levels, allowing for further treatment, while the third patient exhibited a repeated increase in blood calcium, which eventually decreased after parathyroid adenoma resection, leading to clinical discharge. Our findings suggest that RCA-CRRT can help alleviate hypercalcemia crisis, stabilize the patient's internal environment, and provide valuable time for clinical treatment in cases of various medical conditions causing abnormal blood calcium elevations.

在这项研究中,我们探讨了区域性枸橼酸钠抗凝持续肾脏替代疗法(RCA-CRRT)在降低三名不同病因引起的高钙血症危象患者血钙水平方面的有效性。枸橼酸钠螯合钙离子作为抗凝剂用于治疗严重患者。通过调整枸橼酸抗凝剂剂量和监测治疗指标,积极调整RCA-CRRT参数,缓解高钙血症危象,为手术或专科治疗提供时间。两名患者的血钙水平迅速有效下降,为进一步治疗创造了条件,而第三名患者则表现出血钙反复升高,最终在甲状旁腺腺瘤切除术后血钙下降,临床出院。我们的研究结果表明,RCA-CRRT 可以帮助缓解高钙血症危象,稳定患者的内环境,为各种疾病引起的血钙异常升高的临床治疗提供宝贵的时间。
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引用次数: 0
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International Journal of Artificial Organs
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