Platelet function and hemolysis in centrifugal pumps: in vitro investigations.
The effects of centrifugal pumps on blood components other than erythrocytes, namely platelets and their interaction with the coagulation system, are not very well known. In a comparative study with three centrifugal pumps (BioMedicus BP-80, St. Jude Isoflow, and Sarns Delphin) and the Stockert roller pump hemolysis, platelet counts, thromboplastin and partial thromboplastin times, as well as resonance thrombography (RTG) parameters for the assessment of platelet and coagulation function were evaluated in vitro. Normalized indices of hemolysis (NIH) with ACD anticoagulation after 360 minutes were 0.008+/-0.004 (Isoflow), 0.018+/-0.017 (BP-80), 0.085+/-0.051 (Delphin), and 0.049+/-0.010 g/1001 (roller pump). Plasmatic coagulation was activated in all circuits. Platelet function was severely inhibited by the BP-80, indicated by increase in RTG platelet time to 358%+/-150% of initial values compared to 42%+/-29% (Isoflow), 40%+/-20% (Delphin), and 12%+/-10% (roller pump). Fibrin polymerization was affected similarly. The large surface area of the BP-80 leads to an extensive activation of platelets and plasminogen.
Steines
D
D
Helmholtz-Institute for Biomedical Engineering, Aachen, Germany.
Westphal
D
D
Göbel
C
C
Reul
H
H
Rau
G
G
D001777:Blood Coagulation; D004867:Equipment Design; D004869:Equipment Safety; D004912:Erythrocytes / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005112:Extracorporeal Circulation / Q000295:instrumentation*; D005240:Feasibility Studies; D006353:Heart-Assist Devices / Q000009:adverse effects; D006461:Hemolysis; D006801:Humans; D010974:Platelet Aggregation; D010976:Platelet Count; D012016:Reference Values