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1.
J Biomed Nanotechnol ; 16(1): 101-110, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31996289

RESUMO

Large (> 6 mm) artificial blood vessels have been successfully employed in clinic practice. However, small-diameter (< 6 mm) synthetic grafts have not been applied due to their hydrophobicity. In this study, poly-vinylpyrrolidone (PVP) was introduced into poly-L-lactic acid (PLLA) to prepare biodegradable small-diameter electrospun blood vessels which were further modified via electrostatic self-assembly (ESA). The characteristics of PLLA/PVP films were investigated by scanning electron microscopy (SEM), contact angle measurement and mechanical property testing. The cytocompatiblility and blood compatibility of the fiber films were further studied through vascular smooth muscle cells (VSMCs) proliferation and platelet adhesion, and the morphology of cells on films was viewed by laser scanning confocal microscopy (LSCM) and SEM. Next, the surface of ESA-modified electrospun fiber films was analyzed through SEM and photoelectron spectroscopy (XPS). The degradation characteristics of these films were investigated through SEM observation, weight loss, viscosity average molecular weight reduction, and pH change in the testing solutions as well. The films were also subcutaneously implanted in rabbits to analyze the biocompatibility. The results of these experiments showed that electrospun films with PVP possessed a good structure and improved hydrophilicity. The films assembled with chitosan/heparin by ESA were beneficial to VSMCs survival and had excellent blood compatibilities. The data indicated these films were biodegradable with good tissue compatibility. In conclusion, we successfully obtained biodegradable small-diameter blood vessels through electrospinning PLLA/PVP and modifying this blend's surface using ESA. The study provided a feasible method for making small-diameter synthetic blood vessels with improved hydrophilic and anticoagulant properties.


Assuntos
Substitutos Sanguíneos/química , Animais , Materiais Biocompatíveis , Quitosana , Poliésteres , Polímeros , Coelhos , Propriedades de Superfície
2.
Georgian Med News ; (294): 83-87, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687955

RESUMO

The aim of the research was to investigate the relationship between cerebral microembolization and the development of postoperative cognitive impairment in patients after coronary artery bypass grafting with and without prophylactic administration of nitroglycerin at the end of artificial blood circulation. The study included 72 patients (43 male and 29 female) who had ACBPS using an ABCA. The patients were randomized into two clinical groups. The number of patients in the control group was 34 patients, in the study group - 38 patients. The study of the cognitive sphere was performed using a battery of clinical tests that included MSA and MMSE scales, Trail-making test, Grooved Pageboard, fine hands-motor test, 10 words test by AR Luria, Wexler's test, Schultz tables. The assessment was carried out on a day before the intervention and on the fifth day after the surgical intervention. It was shown that by all patients undergoing aorto-coronary bypass syrgery microembolization within the cerebral blood flow had been determined. The vast majority of microemboli is formed at the beginning of artificial blood circulation, at the moment of clamping aorta, as well as during the restoration of effective cardiac activity. Intraoperative microembolization of cerebral blood flow in excess of 750 microemboli leads to clinically significant deterioration of the brain functions in the early postoperative period. When used as a peripheral vasodilator, nitroglycerin, at a dose of 8-10 µg/kg*min in high (120-130%) volume perfusion rate, decreases the number of microemboluses in the basin of СМА by 2.4%.


Assuntos
Aorta/diagnóstico por imagem , Substitutos Sanguíneos , Ponte Cardiopulmonar/efeitos adversos , Disfunção Cognitiva/etiologia , Ponte de Artéria Coronária/efeitos adversos , Embolia Intracraniana/psicologia , Infarto do Miocárdio/cirurgia , Idoso , Idoso de 80 Anos ou mais , Ponte Cardiopulmonar/métodos , Circulação Cerebrovascular , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Ponte de Artéria Coronária/métodos , Feminino , Humanos , Embolia Intracraniana/complicações , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle
3.
Rinsho Ketsueki ; 60(9): 1084-1091, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31597831

RESUMO

The blood supply system for transfusions in Japan functions well. However, in cases of sudden hemorrhagic shock, the swift supply of red blood cell (RBC) product might be difficult, particularly when medical care is required in remote regions and in obstetric medicine, where there is always a risk of hemorrhage. Blood pressure maintenance by infusion of volume expanders, such as crystalloids or colloids, may be insufficient to preserve the function of vital organs because they do not contain any oxygen-carrying molecules. If artificial RBCs were at hand, they could be used as a blood substitute until blood products are received from blood banks. This would save patients without degrading their quality of life. In the 1990s, we developed an artificial RBC in the form of a hemoglobin vesicle (Hb-V). Hb-V is a liposomal microparticle that encloses oxygen-carrying human Hb molecules. Different from RBCs, it has no blood type and is stable at room temperature, ensuring a long shelf-life. Its excellent biocompatibility and oxygen-carrying capacity have been proven in a number of animal experiments, and its production technique has also been established. Therefore, translational research is being designed with the aid of the Japan Agency of Medical Research and Development.


Assuntos
Substitutos Sanguíneos , Eritrócitos , Choque Hemorrágico/terapia , Pesquisa Médica Translacional , Animais , Hemoglobinas , Humanos , Japão , Oxigênio
4.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(5): 355-358, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31625335

RESUMO

Permanent magnet motor has been widely used in the field of artificial heart pump due to its high power density, high stability and easy control. In this paper, the development history and research progress of permanent magnet motor for blood pump were described. Firstly, the motors were classified according to their structures and application scenarios. And then, the measures taken by different types of motors to meet the corresponding performance requirements were introduced, and the specific application cases were given. After that, commonly used control algorithms of these motors were enumerated. What's more, the advantages and disadvantages of the control algorithms and their application emphasis were carefully explained. Finally, the paper was summarized in short.


Assuntos
Substitutos Sanguíneos , Coração Artificial , Magnetismo , Algoritmos , Imãs , Desenho de Prótese
6.
ACS Appl Mater Interfaces ; 11(39): 35604-35612, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31495166

RESUMO

As an oxygen-transporting protein, free hemoglobin (Hb) often suffers from the disadvantage of undesirable stability and short blood circulation, which severely impairs the potential clinical applications as the blood substitute. In this work, Hb was facilely encapsulated into a kind of metal-organic frameworks (MOFs) (ZIF-8) inspired by the natural biomineralization process. The obtained ZIF-8 encapsulating Hb (ZIF-8@Hb) showed the small hydrodynamic size of 180.8 nm and neutral zeta potential of -2.1 mV by adjusting the ratio of Hb in ZIF-8 frameworks. Intriguingly, Hb encapsulated by ZIF-8 exhibited significantly enhanced stability in alkaline, oxidation, high temperature, or enzymatic environment compared with free Hb because of the excellent protective MOF coatings. More importantly, the negative charge of Hb neutralized the original positive charge of ZIF-8, which led to the better biocompatibility, lower protein adsorption, and macrophage uptake of ZIF-8@Hb than bare ZIF-8 nanoparticles. Furthermore, ZIF-8@Hb displayed extended blood circulation with the elimination half-life of 13.9 h as well as reduced nonspecific distribution in normal organs compared with free Hb or ZIF-8 nanoparticles. With the above advantages, ZIF-8@Hb showed significantly extended survival time of mice in a disease model of hemorrhagic shock compared with free Hb or bare ZIF-8 nanoparticles. Overall, this work offers a high-stable and long-circulating oxygen carrier platform, which may find wide applications as a blood substitute to treat various oxygen-relevant diseases.


Assuntos
Substitutos Sanguíneos , Hemoglobinas , Proteínas Imobilizadas , Estruturas Metalorgânicas , Choque Hemorrágico/tratamento farmacológico , Animais , Substitutos Sanguíneos/química , Substitutos Sanguíneos/farmacologia , Hemoglobinas/química , Hemoglobinas/farmacologia , Humanos , Proteínas Imobilizadas/química , Proteínas Imobilizadas/farmacologia , Estruturas Metalorgânicas/química , Estruturas Metalorgânicas/farmacologia , Camundongos , Oxigênio/sangue , Células RAW 264.7 , Choque Hemorrágico/sangue
7.
Transfus Clin Biol ; 26(3): 174-179, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31262629

RESUMO

Whole blood, that is blood that is not manufactured into its component red blood cells (RBC) plasma, and platelets (PLT) units, was the mainstay of transfusion for many years until it was discovered that the component parts of a blood donation could be stored under different conditions thereby optimizing the storage length of each product. The use of low anti-A and -B titer group O whole blood (LTOWB) has recently been rediscovered for use in massively bleeding trauma patients. Whole blood has several advantages over conventional component therapy for these patients, including simplifying the logistics of the resuscitation, being more concentrated than whole blood that is reconstituted from conventional components, and providing cold-stored PLTs, amongst other benefits. While randomized controlled trials to determine the efficacy of using LTOWB in the resuscitation of massively bleeding trauma patients are currently underway, retrospective data has shown that massively bleeding recipients of LTOWB with traumatic injury do not have worse outcomes compared to patients who received conventional components and, in some cases, recipients of LTOWB have more favourable outcomes. This paper will describe some of the advantages of using LTOWB and will discuss the emerging evidence for its use in massively bleeding patients.


Assuntos
Transfusão de Sangue/métodos , Hemorragia/terapia , Doença Aguda , Anticoagulantes/efeitos adversos , Tipagem e Reações Cruzadas Sanguíneas/métodos , Preservação de Sangue/métodos , Substitutos Sanguíneos/efeitos adversos , Substitutos Sanguíneos/uso terapêutico , Citratos/efeitos adversos , Soluções Cristaloides/efeitos adversos , Soluções Cristaloides/uso terapêutico , Serviços Médicos de Emergência , Glucose/efeitos adversos , Hemorragia/etiologia , Humanos , Procedimentos de Redução de Leucócitos , Ressuscitação , Choque Hemorrágico/etiologia , Choque Hemorrágico/mortalidade , Choque Hemorrágico/terapia , Reação Transfusional/prevenção & controle , Resultado do Tratamento , Ferimentos e Lesões/complicações
8.
Molecules ; 24(13)2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31324029

RESUMO

The present study investigated the possibilities and feasibility of drug targeting for an arterial bifurcation lesion to influence the host healing response. A micrometer sized iron particle was used only to model the magnetic carrier in the experimental investigation (not intended for clinical use), to demonstrate the feasibility of the particle targeting at the lesion site and facilitate the new experimental investigations using coated superparamagnetic iron oxide nanoparticles. Magnetic fields were generated by a single permanent external magnet (ferrite magnet). Artery bifurcation exerts severe impacts on drug distribution, both in the main vessel and the branches, practically inducing an uneven drug concentration distribution in the bifurcation lesion area. There are permanently positioned magnets in the vicinity of the bifurcation near the diseased area. The generated magnetic field induced deviation of the injected ferromagnetic particles and were captured onto the vessel wall of the test section. To increase the particle accumulation in the targeted region and consequently avoid the polypharmacology (interaction of the injected drug particles with multiple target sites), it is critical to understand flow hemodynamics and the correlation between flow structure, magnetic field gradient, and spatial position.


Assuntos
Artérias/fisiopatologia , Artérias/efeitos da radiação , Sistemas de Liberação de Medicamentos , Hemodinâmica/efeitos da radiação , Campos Magnéticos , Nanopartículas de Magnetita , Nanomedicina Teranóstica , Algoritmos , Angiografia , Artérias/anormalidades , Artérias/diagnóstico por imagem , Substitutos Sanguíneos , Hemodinâmica/efeitos dos fármacos , Modelos Biológicos , Tamanho da Partícula , Reologia
9.
Rozhl Chir ; 98(6): 233-238, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31331178

RESUMO

The development of a low-flow vascular prosthesis is a very topical issue. The authors present a pathway for the development of a prosthesis with optimal properties based on the idea of mimicking the characteristics of a biological model (saphenous vein graft) and programming these properties in the model of the prosthetic substitute. The vascular prosthesis presented consists of three layers - a non-absorbable scaffold representing vascular “media”, and two absorbable collagen layers - pseudointima and pseudoadventitia. The basic methods of physical testing are presented - the single axis stretch test and inflation-extension test, as well as other procedures that affect the final properties. These include collagen curing, antithrombotic treatment of the inner layer and the use of sterilization methods. The designed new graft was successfully implanted in an ovine model.


Assuntos
Substitutos Sanguíneos , Prótese Vascular , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares , Animais , Humanos , Veia Safena , Ovinos
10.
Artif Cells Nanomed Biotechnol ; 47(1): 3123-3128, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31352837

RESUMO

Hemoglobin-vesicles (HbVs) are artificial oxygen carriers encapsulating purified and concentrated hemoglobin solution in phospholipid vesicles (liposomes) and their safety and efficacy as a transfusion alternative have been evaluated. Because of the absence of enzymatic methemoglobin reduction system in HbV, the level of ferric methemoglobin (metHb) increases gradually after intravenous administration. Our previous studies clarified that the glycolytic electron energies, charged as NAD(P)H in red blood cells (RBC), are donated to reduce metHb compartmentalized in HbV via a water-soluble electron mediator such as methylene blue [MB; 3,7-bis(dimethylamino)phenothiazinium chloride], which freely shuttle across both RBC biomembrane and HbV lipid membrane. Herein, we tried to test repeated injections of MB after the massive HbV administration (28 mL/kg) to hemorrhagic shocked Wistar rats (n = 3). MB was injected (3.1 mg/kg) at 7, 24 and 48 h after HbV administration. Every MB injection showed rapid reduction of metHb and gradual reversal increase. As a result, the functional life span of HbV was significantly extended over 60 h. It is expected that further optimization of injection scheduling will decrease the total amount of MB and prolong the functional life span of HbV.


Assuntos
Circulação Sanguínea/efeitos dos fármacos , Substitutos Sanguíneos/farmacologia , Eritrócitos/efeitos dos fármacos , Azul de Metileno/farmacologia , Animais , Interações de Medicamentos , Eritrócitos/metabolismo , Injeções , Metemoglobina/metabolismo , Azul de Metileno/administração & dosagem , Ratos , Ratos Wistar , Fatores de Tempo
11.
J Trauma Acute Care Surg ; 87(2): 263-273, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31348400

RESUMO

BACKGROUND: Hemorrhage-induced traumatic cardiac arrest (HiTCA) has a dismal survival rate. Previous studies demonstrated selective aortic arch perfusion (SAAP) with fresh whole blood (FWB) improved the rate of return of spontaneous circulation (ROSC) after HiTCA, compared with resuscitative endovascular balloon occlusion of the aorta and cardiopulmonary resuscitation (CPR). Hemoglobin-based oxygen carriers, such as hemoglobin-based oxygen carrier (HBOC)-201, may alleviate the logistical constraints of using FWB in a prehospital setting. It is unknown whether SAAP with HBOC-201 is equivalent in efficacy to FWB, whether conversion from SAAP to extracorporeal life support (ECLS) is feasible, and whether physiologic derangement post-SAAP therapy is reversible. METHODS: Twenty-six swine (79 ± 4 kg) were anesthetized and underwent HiTCA which was induced via liver injury and controlled hemorrhage. Following arrest, swine were randomly allocated to resuscitation using SAAP with FWB (n = 12) or HBOC-201 (n = 14). After SAAP was initiated, animals were monitored for a 20-minute prehospital period prior to a 40-minute damage control surgery and resuscitation phase, followed by 260 minutes of critical care. Primary outcomes included rate of ROSC, survival, conversion to ECLS, and correction of physiology. RESULTS: Baseline physiologic measurements were similar between groups. ROSC was achieved in 100% of the FWB animals and 86% of the HBOC-201 animals (p = 0.483). Survival (t = 320 minutes) was 92% (11/12) in the FWB group and 67% (8/12) in the HBOC-201 group (p = 0.120). Conversion to ECLS was successful in 100% of both groups. Lactate peaked at 80 minutes in both groups, and significantly improved by the end of the experiment in the HBOC-201 group (p = 0.001) but not in the FWB group (p = 0.104). There was no significant difference in peak or end lactate between groups. CONCLUSION: Selective aortic arch perfusion is effective in eliciting ROSC after HiTCA in a swine model, using either FWB or HBOC-201. Transition from SAAP to ECLS after definitive hemorrhage control is feasible, resulting in high overall survival and improvement in lactic acidosis over the study period.


Assuntos
Aorta Torácica , Substitutos Sanguíneos/uso terapêutico , Transfusão de Sangue/métodos , Reanimação Cardiopulmonar/métodos , Exsanguinação/complicações , Parada Cardíaca/prevenção & controle , Hemoglobinas/uso terapêutico , Perfusão/métodos , Animais , Substitutos Sanguíneos/administração & dosagem , Modelos Animais de Doenças , Exsanguinação/terapia , Parada Cardíaca/etiologia , Hemoglobinas/administração & dosagem , Masculino , Suínos
12.
Med. intensiva (Madr., Ed. impr.) ; 43(5): 281-289, jun.-jul. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183240

RESUMO

Objetivos: Analizar las complicaciones hematológicas y las necesidades transfusionales en niños tratados con oxigenación por membrana extracorpórea (ECMO). Diseño: Estudio retrospectivo. Ámbito: Unidad de cuidados intensivos pediátricos. Pacientes: Niños menores de 18 años tratados con ECMO entre septiembre de 2006 y noviembre de 2015. Intervenciones: Ninguna. Variables de interés: Características clínicas, de la ECMO, anticoagulación, parámetros hematológicos y de coagulación, transfusiones y evolución clínica. Resultados: Se estudiaron 100 pacientes con una mediana de edad de 11 meses. Presentaron sangrado 76; el mediastino fue la localización más frecuente; 39 precisaron revisión quirúrgica. En los primeros 3 días de ECMO, el 97% de los pacientes precisaron transfusión de hematíes (34,4 ml/kg al día), el 94% plaquetas (21,1ml/kg al día) y el 90% plasma (26,6ml/kg al día). Los pacientes posquirúrgicos, con imposibilidad de salida de la circulación extracorpórea, los que presentaron sangrado al inicio de la ECMO, los que precisaron revisión quirúrgica y los que tuvieron canulación transtorácica requirieron mayor volumen de transfusiones. Se produjeron tromboembolias en 14 pacientes y hemólisis en 33. La mortalidad de los niños que presentaron sangrado al inicio de ECMO (57,6%) fue significativamente mayor que la del resto (37,5%) (p = 0,048). Conclusiones: Los niños tratados con ECMO presentan una elevada incidencia de sangrado y precisan un gran volumen de transfusiones. El postoperatorio de cirugía, el sangrado al inicio de la ECMO, la necesidad de revisión quirúrgica, la imposibilidad de salida de la circulación extracorpórea y la canulación transtorácica se asocian a un mayor volumen de transfusiones. Los niños que sangraron al inicio de la ECMO presentaron mayor mortalidad


Objectives: To analyze the hematological complications and need for transfusions in children receiving extracorporeal life support (ECLS). Design: A retrospective study was carried out. Setting: A pediatric intensive care unit. Patients: Children under 18 years of age subjected to ECLS between September 2006 and November 2015. Interventions: None. Variables of interest: Patient and ECLS characteristics, anticoagulation, hematological and coagulation parameters, transfusions and clinical course. Results: A total of 100 patients (94 with heart disease) with a median age of 11 months were studied. Seventy-six patients presented bleeding. The most frequent bleeding point was the mediastinum and 39 patients required revision surgery. In the first 3days, 97% of the patients required blood transfusion (34.4ml/kg per day), 94% platelets (21.1ml/kg per day) and 90% plasma (26.6ml/kg per day). Patients who were in the postoperative period, those who were bleeding at the start of ECLS, those requiring revision surgery, those who could not suspend extracorporeal circulation, and those subjected to transthoracic cannulation required a greater volume of transfusions than the rest of the patients. Thromboembolism occurred in 14 patients and hemolysis in 33 patients. Mortality among the children who were bleeding at the start of ECLS (57.6%) was significantly higher than in the rest of the patients (37.5%) (P=.048). Conclusions: Children subjected to ECLS present high blood product needs. The main factors related to transfusions were the postoperative period, bleeding at the start of ECLS, revision surgery, transthoracic cannulation, and the impossibility of suspending extracorporeal circulation. Children with bleeding suffered greater mortality than the rest of the patients


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Oxigenação por Membrana Extracorpórea/métodos , Transfusão de Sangue/tendências , Unidades de Terapia Intensiva Pediátrica , Doenças Hematológicas/sangue , Estudos Retrospectivos , Substitutos Sanguíneos/uso terapêutico , Tromboembolia/mortalidade , Mortalidade Infantil , Hemorragia/complicações , Anticoagulantes , Modelos Logísticos , Hemólise , Doenças Hematológicas/complicações , Doenças Hematológicas/etiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-31204626

RESUMO

Artificial blood is an innovative concept of transfusion medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body to replace this function of allogenic human blood transfusion. Several molecules have been developed in the past few decades to achieve this objective and continous refinements are being continuously made in the quest of the ideal blood substitute. Currently, available technology manufactures artificial blood from haemoglobin obtained from outdated human/bovine blood (Haemoglobin Based Oxygen Carriers) or utilizing Perfluorocarbons. These synthetic blood substitutes are advantageous in that they do not require compatibility testing, are free from blood borne infections, have prolonged shelf life and do not require refrigeration. Artificial blood is projected to have a significant impact on the development of medical care in the future. It can complement the current blood products for transfusion and create a stable supply of safe and effective products. It is likely to reduce the requirements of blood transfusions drastically especially in settings of trauma and surgery thereby reducing the reliance on banked donated blood.


Assuntos
Substitutos Sanguíneos/uso terapêutico , Anemia/terapia , Animais , Substitutos Sanguíneos/farmacologia , Transfusão de Sangue , Fluorcarbonetos/farmacologia , Fluorcarbonetos/uso terapêutico , Hemoglobinas/farmacologia , Hemoglobinas/uso terapêutico , Humanos , Ressuscitação
14.
Medicine (Baltimore) ; 98(21): e15756, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124960

RESUMO

Medication use during pregnancy is gradually increasing; however, the safety of this practice remains largely unknown.We investigated medications with the most adverse drug reactions (ADRs) among pregnant women and the clinical features of those medications.Reports of ADRs among pregnant women were extracted from the Korea Adverse Events Reporting System (January 2012-December 2015). We analyzed the data of drugs frequently reported to cause ADRs and their clinical features among 3 age groups.A total of 5642 ADRs among 3428 patients were analyzed. The number of ADR reports increased annually. The most common drug categories causing ADRs were analgesics, followed by gynecologic, uterotocolytic, anti-infective, antidiabetic, analgesic, and antihypertensive drugs. Analgesics comprised 6 opioids (morphine, fentanyl, hydromorphone, oxycodone, tramadol, pethidine) and an anti-pyretics (nefopam and ketorolac). As an individual drug, ritodrine (24.4%) was the most frequently reported, followed by morphine, 5-HT3 serotonin antagonist, nefopam, fentanyl, magnesium sulfate, insulin lispro, cefazedone, sodium chloride, hydromorphone, oxycodone, cefotetan, nifedipine, human insulin, tramadol, ketorolac, pethidine, methylergometrine, metoclopramide, and misoprostol (in that order). ADRs most frequently occurred in women aged 25 to 34 years, and the trend of ADR with the 20 most commonly reported medications significantly differed among the age groups (P = .011). In addition, the kind of common causative drugs was different among the age groups.Knowledge of medications and clinical conditions resulting in the highest ADR rates among pregnant women is necessary for medical practitioners to administer proper care.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Adolescente , Adulto , Fatores Etários , Analgésicos/efeitos adversos , Analgésicos Opioides/efeitos adversos , Antibacterianos/efeitos adversos , Antieméticos/efeitos adversos , Substitutos Sanguíneos/efeitos adversos , Fármacos Cardiovasculares/efeitos adversos , Feminino , Humanos , Hipoglicemiantes/efeitos adversos , Pessoa de Meia-Idade , Gravidez , República da Coreia/epidemiologia , Ritodrina , Índice de Gravidade de Doença , Adulto Jovem
15.
Artif Cells Nanomed Biotechnol ; 47(1): 1496-1504, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30983419

RESUMO

Pathological hypoxia-induced organ dysfunction contributes to the high mortality of sepsis. Because of the microcirculation dysfunction following severe sepsis, it is difficult for erythrocytes to transport oxygen to hypoxic tissues. Haemoglobin-based oxygen carriers (HBOCs) are capable of delivering oxygen to hypoxic tissues. The aim of this study is to observe the potential benefits of a novel bovine-derived, non-polymerized, cell-free HBOC solution, YQ23, on sepsis in rats. Cecum ligation and puncture was performed to induce sepsis in Sprague-Dawley rats. Effects of Lactate Ringer's solution (LR), YQ23, and whole blood on oxygen delivery and consumption, mitochondrial function, organ protection and animal survival were observed. LR failed to restore oxygen delivery and the therapeutic effects were limited, whereas low dosage of YQ23 and whole blood significantly increased the tissue oxygen delivery and consumption, improved the mitochondrial function of heart, liver, kidney and intestine, prevented the vital organs injuries and improved the animal survival. The effects of 0.15 g·kg-1 YQ23 resembled that of the whole blood. In addition, YQ23 did not induce renal toxicity, severe oxidative effect and acute vasoconstriction. Thus, YQ23 is a safe and effective resuscitation fluid for sepsis.


Assuntos
Substitutos Sanguíneos/química , Substitutos Sanguíneos/farmacologia , Hemoglobinas/química , Hemoglobinas/farmacologia , Sepse/tratamento farmacológico , Animais , Substitutos Sanguíneos/uso terapêutico , Bovinos , Hemoglobinas/uso terapêutico , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Oxigênio/metabolismo , Ratos , Ratos Sprague-Dawley , Sepse/metabolismo , Sepse/patologia , Sepse/fisiopatologia
16.
Artif Cells Nanomed Biotechnol ; 47(1): 997-1013, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30945957

RESUMO

It is only in the last 20 years that many of the original ideas on artificial cells are being increasingly applied and extended by researchers around the world. Artificial cell has now evolved into nanomedicine, biotherapeutics, blood substitutes, drug delivery, enzyme/gene therapy, cancer therapy, cell/stem cell therapy, nanoparticles, liposomes, bioencapsulation, replicating synthetic cells, cell encapsulation/scaffold, biosorbent/immunosorbent haemoperfusion/plasmapheresis, regenerative medicine, encapsulated microbe, nanobiotechnology, nanotechnology and other areas. More futuristic research includes nanorobot, nanocomputer, multimodal locomotion delivery robot and others. This review starts with a general overview followed by specific examples in more details.


Assuntos
Células Artificiais , Terapia Enzimática/métodos , Hemoperfusão/métodos , Nanomedicina/métodos , Neoplasias/terapia , Plasmaferese/métodos , Medicina Regenerativa/métodos , Animais , Biotecnologia , Substitutos Sanguíneos , Cápsulas , Humanos , Imunoadsorventes , Lipossomos , Microbiologia , Nanopartículas , Neoplasias/genética , Transplante de Células-Tronco
17.
J Pharmacol Exp Ther ; 369(2): 300-310, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30837280

RESUMO

Blood transfusions are a daily practice in hospitals. Since these products are limited in availability and have various, harmful side effects, researchers have pursued the goal to develop artificial blood components for about 40 years. Development of oxygen therapeutics and stem cells are more recent goals. Medline (https://www.ncbi.nlm.nih.gov/pubmed/?holding=ideudelib), ClinicalTrials.gov (https://clinicaltrials.gov), EU Clinical Trials Register (https://www.clinicaltrialsregister.eu), and Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au) were searched up to July 2018 using search terms related to artificial blood products in order to identify new and ongoing research over the last 5 years. However, for products that are already well known and important to or relevant in gaining a better understanding of this field of research, the reader is punctually referred to some important articles published over 5 years ago. This review includes not only clinically relevant substances such as heme-oxygenating carriers, perfluorocarbon-based oxygen carriers, stem cells, and organ conservation, but also includes interesting preclinically advanced compounds depicting the pipeline of potential new products. In- depth insights into specific benefits and limitations of each substance, including the biochemical and physiologic background are included. "Fancy" ideas such as iron-based substances, O2 microbubbles, cyclodextranes, or lugworms are also elucidated. To conclude, this systematic up-to-date review includes all actual achievements and ongoing clinical trials in the field of artificial blood products to pursue the dream of artificial oxygen carrier supply. Research is on the right track, but the task is demanding and challenging.


Assuntos
Oxigênio/metabolismo , Substitutos Sanguíneos/metabolismo , Transfusão de Sangue , Humanos
18.
Artif Cells Nanomed Biotechnol ; 47(1): 783-789, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30873883

RESUMO

The aim of this paper was to create an in vitro setup to quantify the oxygen offloading capabilities of dodecafluoropentane emulsion (DDFPe) in a hypoxic environment. Oxygen offloading from DDFPe was characterized under different gaseous environments and under pre-oxygenated conditions. Results of this study showed that (1) oxygen offloading is inversely related to the solubility of the selected sparging gas in saline and (2) both pre-oxygenated and simultaneously oxygenated DDFPe display similar magnitudes of oxygen transport. These results could be applicable to on-going and future studies involving a variety of hypoxic conditions where oxygen delivery might be therapeutically beneficial.


Assuntos
Substitutos Sanguíneos/química , Fluorcarbonetos/química , Modelos Químicos , Oxigênio/química , Emulsões , Gases/química , Gases/metabolismo , Hipóxia/metabolismo , Oxigênio/metabolismo , Solubilidade
19.
Artif Cells Nanomed Biotechnol ; 47(1): 852-861, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30873884

RESUMO

Hemoglobin-based oxygen carriers (HBOCs) are modified stroma-free hemoglobin molecules used in developing a blood substitute for therapeutic usage. In order to prevent hemoglobin dissociation, glutaraldehyde (GTA) was used to generate high-molecular weight heterogeneous crocodile hemoglobin (Poly-cHb). This work, Poly-cHb was created using various GTA concentrations, ranging from 0.025-0.150% (v/v). Physicochemical properties were investigated that were comparable GTA polymerized human hemoglobin (Poly-hHb). This study has revealed that GTA polymerization increases the molecular size of Native-cHbs from 14.10 nm over a range from 16.31 to 54.27 nm. Moreover, this polymerization alters the secondary structure and heme environment by decreasing the helicity ratio from 1.00 to 0.95 at the highest condition and exhibits hypochromic shift of the Soret band to be 0.88 times lower than the native. However, all Poly-cHbs still possessed higher oxygen affinity than that of Poly-hHbs with average P50 values of 13 and 21 mmHg, respectively. Although, polymerization affected the overall Poly-cHb structure slightly, but compensated by decreasing the denaturation level to lower than 10%. Thus, it is interesting to note that Poly-cHb may advantageously provide effective oxygen carriage and ability for pasteurization, which may benefit the search for new alternative hemoglobin sources for HBOC development.


Assuntos
Substitutos Sanguíneos/química , Glutaral/química , Hemoglobinas/química , Oxigênio/química , Jacarés e Crocodilos , Animais , Humanos , Peso Molecular , Polimerização , Conformação Proteica , Temperatura Ambiente
20.
Artif Cells Nanomed Biotechnol ; 47(1): 95-103, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30739524

RESUMO

Hypoxia drives sickle cell disease (SCD) by inducing sickle cell haemoglobin to polymerize and deform red blood cells (RBC) into the sickle shape. A novel carboxyhaemoglobin-based oxygen carrier (PEG-COHb; PP-007) promotes unsickling in vitro by relieving RBC hypoxia. An in vivo rat model of vaso-occlusive crisis (VOC) capable of accommodating a suite of physiological and microcirculatory measurements was used to compare treatment with PEG-COHb to a non-oxygen carrying control solution (lactated ringer's [LRS]). Male Sprague-Dawley rats were anesthetized and surgically prepared to monitor microvascular interstitial oxygenation (PISFO2), cardiovascular parameters and blood chemistry. Human homozygous SCD RBCs were isolated and exchange transfused into the rats until the distal microcirculation of the exteriorized spinotrapezius muscle was hypoxic and RBC aggregates were visualized. VOC was left untreated (Sham) or treated 15 min later with PEG-COHb or LRS and observed for up to 4 h. Treatment with PEG-COHb showed better improvement of PISFO2, end-point lactate, mean arterial pressure and survival duration compared to Sham and LRS. Restoring PISFO2 was associated with relieving the RBC aggregates driving VOC, which then affected other study metrics. Compared to LRS, PEG-COHb's oxygen-carrying properties were key to improved outcomes.


Assuntos
Anemia Falciforme , Substitutos Sanguíneos , Carboxihemoglobina , Microcirculação/efeitos dos fármacos , Anemia Falciforme/sangue , Anemia Falciforme/tratamento farmacológico , Animais , Substitutos Sanguíneos/química , Substitutos Sanguíneos/farmacologia , Carboxihemoglobina/química , Carboxihemoglobina/farmacologia , Humanos , Masculino , Oxigênio/sangue , Ratos , Ratos Sprague-Dawley
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