THROMBOGENESIS IN BLOOD PUMPING DEVICES

设备相关血栓栓塞症是血液接触中的主要问题。 假体装置(例如氧合器、全人工心脏、心脏 辅助设备、肾脏、肺等)并导致严重的并发症。 用药物控制血栓栓塞的尝试并不总是成功的， 主要是因为血栓栓塞化的过程是启动的 这是由许多因素支撑的，其中许多因素还没有得到很好的理解。 该装置的设计和由此产生的流动模式、性质和 所用材料的组成和凝聚状态 设备的接受者，所有人都在血栓形成过程中做出贡献。 这项建议是关于血泵(脑室)血栓形成的研究 辅助设备、体外循环) 调查团队和新颖的技术。生物医学领域的研究人员 和工程背景将调查事件的顺序， 导致血栓栓塞术。外化小牛体外模型的建立 带有光散射探测器的透明左心室辅助装置 将使用安装在流出管道中的肾脏和移位肾脏。一个 光散射检测器不仅可以检测通过的微栓子 通过探测器单元，它还将测量它们的大小和频率。 过滤模型将确定这些微栓子是否有可能 闭塞较小的血管，移位的肾脏将表明 微栓子滞留在肾脏的百分比。这三种方法 将互为补充，提供有关 血栓栓子现象的发生及其随时间的进展。这个 分析血流的贡献及其对血栓栓塞症的影响。 同样，所提出的量化方法可能被证明是在 建立用药方案控制血吸虫病的有效性 血栓栓塞症。肝素和阿司匹林这两种药物的作用将是 仔细检查过。在这项研究的过程中，一些人 血液学参数将被监测以帮助识别早期标志物 血液循环中的血栓形成。这些努力应该会帮助我们更好地 了解血栓形成的过程，提供哪里的线索 血栓形成是启动的，流变因素的作用，以及 生物材料，并可能有助于为消除不利影响铺平道路 通过修改设计、改善材料表面或适当地 治疗药物的组合。

Device-associated thromboembolism is a major problem in blood-contacting prosthetic devices (e.g. oxygenators, total artificial hearts, ventricular assist devices, kidneys, lungs, etc.) and cause severe complications. ATtempts to control thromboembolism with drugs are not always successful, primarily because the process of thromboembolization is initiated and sustained by a number of factors, many of which are not well understood. The design of the device and resulting flow patterns, the nature and composition of the materials used, and the coagulation state of the recipient of the device, all contribute in the process of thrombogenesis. This proposal is a study of thrombogenesis in blood pumps (ventricular assist devices, extracorporeal circulations) with the help of an unique team of investigators and novel techniques. Researchers with biomedical and engineering background will investigate the sequence of events that lead to thromboembolization. An ex-vivo calf model with externalized transparent left ventricular assist device with a light scattering detector installed in the outflow conduit and a transposed kidney will be used. A light scattering detector will detect not only the microemboli passing through the detector cell, it will also measure their size and frequency. A filtration model will determine the potential of these microemboli to occlude smaller blood vessels, the transposed kidney will indicate the percentage of the microemboli lodged in the kidney. These three methods will complement each other in providing useful information concerning the onset of the thromboembolic phenomena and its progress over the time. The contribution of flow and its impact on thromboembolism will be analyzed. Similarly, the proposed quantitation methods may prove ideal in establishing the effectiveness of drug regimen in controlling the thromboembolism. The effect of 2 drugs, heparin and aspirin, will be carefully examined. During the course of this study, a number of hematologic parameters will be monitored to help identify early markers of thrombogenesis in circulating blood. These efforts should help us better understand the process of thrombogenesis, provide clues as to where thrombogenesis is initiated, the role of rheological factors, and the biomaterials, and may help pave the way for elimination of adverse effects by design modifications, improved material surfaces, or appropriate combination of therapeutic agents.