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Transfusion medicine
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
It is useful to return to the DGAMS report following ATACCC in August 2004 mentioned earlier in this chapter. DGAMS had highlighted the need to maintain an overview of current research in order to identify the areas that the United Kingdom could complement. The themes of the programme included organisational issues, command and control and managing bleeding. Subsequent advances in pre-hospital care have successfully delivered a range of tools to the frontline soldier. The need to gain better access has been met by the introduction of a variety of inter-osseous devices. Delivery has been further enhanced by warming devices and rapid fluid delivery systems. The debate regarding fluids is the province of others. However, artificial ‘blood’ has not progressed. Whole blood and blood components have increasingly been adopted as the best way to meet the needs of volume, oxygenation and haemostasis. Conversely, team training is mature and access to clinical decision support was delivered in 2016.
Applied surgical science
Published in Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury, OSCEs for the MRCS Part B, 2017
Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury
Blood substitution: Crystalloids and/or colloidsArtificial blood substitutes (currently confined to clinical trials)
The Arterially Perfused Rabbit Papillary Muscle: A Model to Study Electrical Properties in Myocardial Ischemia
Published in Samuel Sideman, Rafael Beyar, Analysis and Simulation of the Cardiac System — Ischemia, 2020
André G. Kléber, Christoph Riegger
The perfusate was composed of washed bovine erythrocytes (hematocrit of 25%), albumin (2 g/l), dextran Mr 70,000, 40 g/l, insulin (1 U/l), heparin (400 U/l), glucose (20 mM), and 10ns of the following concentrations (millimolar): Na+, 149; K+, 4.5; Mg2+, 0.49; Ca2+, 1.8; Cl−, 133; HCO3−, 25; and H2PO4−, 0.4. The pH was set to 7.35 to 7.45 during normal perfusion. A detailed description of the perfusion apparatus and the recording chamber is given elsewhere.13 The perfusate was driven by a roller pump to the preparation. Equilibration of the “artificial blood” with a mixture of O2/CO2 (normoxia) was achieved with a membrane oxygenator. The perfusion pressure ranged from 40 to 45 mmHg; the flow rate was 80 to 100 ml/min/100 g. The preparation was placed on a Perspex platform covered with wax. It contained a large electrode which was in contact with an electrical ground. The platform was positioned at an angle of 30 to 40° from the horizontal plane. The apical end of the papillary muscle was fixed to a Perspex holder which was attached to a micromanipulator. This holder served to fix the papillary muscle in a horizontal position and to adjust its resting length (about + 20% of slack length). Subthreshold or excitatory current pulses (double threshold strength) were applied between an electrode (platinum wire) at the tip of the muscle and the large electrode at the base. In such a way, an arterially perfused papillary muscle was obtained which had a constant diameter (cylindrical or slightly ellipsoid shape) and which was surrounded by the artificial atmosphere of the recording chamber, (see Figure 1). Both a constant cross-sectional area and an electrical insulator are essential requirements for the performance of cable analysis. Temperature was maintained constant at 35°C by warming the tubing containing the perfusate and the gas mixture in a water bath. In addition, the double-walled cover of the recording chamber was warmed with the water from the thermostat.
Capsules from synthetic diblock-peptides as potential artificial oxygen carriers
Published in Journal of Microencapsulation, 2021
Huayang Feng, Jürgen Linders, Sascha Myszkowska, Christian Mayer
This study is meant to explore the feasibility of synthesising amphiphilic diblock-peptides by a phosgene-free method and their potential application for PFD-filled capsules (Scheme 1). The polypeptide consists of blocks of poly aspartic acid and poly phenylalanine, whose chemical structure is identified using 1H-NMR. The morphology and size distribution of the PFD-filled capsules is investigated with atomic force microscopy (AFM) and particle tracking via video microscopy (VM). The molecule diffusion and gas exchange properties of the capsules are studied by Pulsed Field-Gradient Nuclear Magnetic Resonance (PFG-NMR) and 19F-NMR. The results indicate that diblock-peptides synthesised by the proposed phosgene-free method lead to PFD-filled capsules which are very suitable as artificial oxygen carriers. Of course, in order to be applicable as oxygen carriers for artificial blood replacement, the capsules will have to pass further testing, e.g. for blood compatibility, cellular toxicity, allergenic potential, and metabolic degradation. But being composed only of canonical amino acids and offering a wide variety towards their choice, chances are very good to reach this target in future developments.
Synthesis and characterisation of aqueous haemoglobin-based microcapsules coated by genipin-cross-linked albumin
Published in Journal of Microencapsulation, 2020
Kai Melvin Schakowski, Jürgen Linders, Katja Bettina Ferenz, Michael Kirsch
Shortage on erythrocytes always coincides with shortage on long-term oxygen supply, as a sufficient quota of haemoglobin must be assured in order to secure adequate sustenance. Due to scarcity on RBCs, alternative ways of sustaining blood oxygen levels must be deduced. Within the last years artificial blood substitutes have gained more and more attention because of the above mentioned decrease of available RBCs (Ruchalla 2013, Njoku et al.2015, Chung et al.2016, Ellingson et al.2017, Taguchi et al.2017, Ferenz and Steinbicker 2019). Since the application of a pure solution of haemoglobin is impractical due to the enormous nephrotoxicity and short circulation time (Chang 2006), several different attempts have been made to create biocompatible artificial oxygen carriers, based on either perfluorocarbons or haemoglobin that needs to be encapsulated in protective shells in any case (Bauer et al.2010, von Storp et al.2012, Ferenz et al.2013, Sakai et al.2013, Stephan et al.2014, Wrobeln et al.2017a, 2017b).
ID CORE XT as a tool for molecular red blood cell typing
Published in Expert Review of Molecular Diagnostics, 2019
Carolina Bonet Bub, Lilian Castilho
New technologies based on molecular biology already exist, will be improved, and new technologies are coming. If on the one hand the current molecular biology platforms cannot embrace all the genetic variants, on the other hand NGS platforms generate a huge amount of data that not yet have clinical relevance. A balance between actual and future technologies will be necessary, including correct interpretation of the data generated, affordable costs for the techniques and theoretical/practical training in molecular immunohematology is still in need [43]. Transfusion medicine has come a long way, it has seen many revolutions and improvements: typing blood products using molecular means being one. This technology should be around for a while until a universal and artificial blood substitute that is free of infectious agents and residual toxicity becomes available [44].