Mild hypothermia, as a common means of intraoperative nerve protection, has been used in clinical practice. Compared with the traditional methods such as freezing helmet and nasopharyngeal cooling, hypothermic blood perfusion is considered to be a promising treatment for mild hypothermia, but it lacks experimental and theoretical verification of its cooling effect. In this study, the commercial finite element simulation software COMSOL combined the Pennes equation with the cerebrovascular network model to construct a new simplified human brain model, which was further used to simulate the cooling process of cerebral hypothermic blood perfusion. When the hypothermic blood perfusion was 33 ℃, the human brain could enter the mild hypothermic state within 4 minutes. By comparing with helmet cooling, the feasibility and efficiency of the blood perfusion scheme were verified. By comparing with the calculation results based on Pennes equation, the rationality of the model constructed in this study were verified. This model can non-intrusively predict the changes of brain temperature during surgery, and provide a reference for the setting of treatment parameters such as blood temperature, so as to provide personalized realization of safer and more effective mild hypothermia neuro protection.
Humans ; Hypothermia, Induced/methods* ; Hypothermia ; Hemoperfusion ; Brain/physiology* ; Body Temperature

Aconitum ; poisoning ; Animals ; Disease Models, Animal ; Female ; Hemoperfusion ; methods ; Male ; Plant Poisoning ; therapy ; Rabbits

OBJECTIVETo investigate the different effect of three methods of blood purification for paraquat poisoning patients:hemoperfusion (HP), hemoperfusion combined with hemodialysis (HP + HD), hemoperfusion combined with continuous veno-venous hemofiltration (HP + CVVH).

METHODS72 cases of paraquat poisoning patients were divided into three groups after giving conventional therapy HP group, HP + HD group, HP + CVVH group. Compared the rate of decline concentrations of paraquat in blood, the liver and the kidney damage between before and after blood purification and contrast the mortality in three groups after different method of blood purification.

RESULTSThe rate of decline concentrations of paraquat in blood of the HP + HD group and HP + CVVH group were both significantly greater than the HP group, but this result of HP + HD group has no significant difference compared with HP + CVVH group; Among the three groups of patients after 72 hours, the degree of dysfunction of liver of the HP + HD group and HP + CVVH group were both significantly lower than the HP group, whilely the degree of dysfunction of kidney of the HP + HD group was significantly lower than the HP group and the HP + CVVH group. The survival time of the HP + HD group and the HP + CVVH group were significant linger than the HP group, but the comparison among the three groups had no significant difference in mortality.

CONCLUSIONThree blood purification methods can effectively remove paraquat absorbed into the blood, and the hemoperfusion combined with hemodialysis or continuous veno-venous hemofiltration can effectively reduce the degree of damage of liver and kidney and also can prolong survival time, but did not significantly improve the survival rate of patients.

Hemofiltration ; methods ; Hemoperfusion ; Humans ; Kidney ; Liver ; Paraquat ; blood ; toxicity ; Renal Dialysis ; Survival Rate ; Treatment Outcome

This study in pursuit of the synthetic technologies and structure characterization of polyacrylamide-based matrices (PAM beads) for low density lipoprotein (LDL) adsorbent and their adsorbability for LDL was intended for an experimental evidence of developing advanced matrices for LDL adsorbent. PAM beads were synthesized by inverse suspension polymerization, and their structure characterization was characterized by SEM, image analyzer and small angle X-ray scattering. The tripeptide serine-aspartic-glutamic acid (SDE) was coupled on the PAM beads to prepare the LDL adsorbents whose adsorbability for LDL was determined in vitro. The results showed that the PAM beads with the average size diameter 142.1 microm and the average pore diameter 119.8 nm could act as the matrices in accordance with the requirement of adsorbent for LDL. When the amount of acrylamide and the crosslinking agent N,N'-methylene-bis(acrylamide) was fixed, the average pore diameter decreased with the increase of the crosslinking agent content. Although the nonspecific binding of PAM beads for LDL was low, they could selectively adsorb LDL after coupling the SDE on the PAM beads.
Acrylic Resins ; chemical synthesis ; Adsorption ; Blood Component Removal ; methods ; Cross-Linking Reagents ; Hemoperfusion ; instrumentation ; methods ; Humans ; Lipoproteins, LDL ; Microspheres

OBJECTIVETo explore the effect of hemoperfusion(HP) about the patients of methamidophos poisoning.

METHODSOn the basis of comprehensive treatment,15 cases of severe acute methamidophos poisoning patients were treated with HP, Blood samples were collected at 7 time points, before and 5, 15, 30, 45, 60mins following the beginning and the end of hemoperfusion. Blood samples were used for measuring the concentration of methamidophos and perfusion devices were used for measuring the volume of methamidophos adsorbed by the device after hemoperfusion.

RESULTS15 patients live in 12 cases, 3 cases of death. HP (former) blood Cholinesterase vigor were 662.60 + 632.05, HP (after) blood cholinesterase vigor were 2577.52 + 920.38 IU/L; The difference of blood Cholinesterase vigor between the before and after HP was statistically significant (P < 0.01). The patients' methamidophos concentration of blood when HP treated 45, 60, 120 min were respectively (851 + 672), (680 + 529), (587 + 520) microg /ml, there were significantly lower than that the patients' methamidophos concentration of blood who were before HP (1659 + 1105) microg/ml, a statistically significant difference (P < 0.01).

CONCLUSIONHP can be cut down obviously methamidophos poisoning patients serum concentrations of toxic, the experimental method directly prove the clinical application of carbon HP can really adsorption methamidophos.

Adult ; Cholinesterases ; metabolism ; Female ; Hemoperfusion ; methods ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organothiophosphorus Compounds ; poisoning ; Treatment Outcome ; Young Adult

In this paper, the adsorbent properties of Polymyxin B immobilized polystyrene microbeads to remove endotoxin from plasma were studied and the factors that affected the absorption of endotoxin were discussed. The rat models of endotoxemia were established, which were used in hemoperfusion. The experiment results indicated that the novel affinity adsorbent could remove endotoxin from plasma effectively. Moreover, the results also showed that Polymyxin B immobilized polystyrene microbeads was a fine biomaterial of hemoperfusion as well as exhibited a satisfactory blood compatibility.
Adsorption ; Animals ; Endotoxemia ; blood ; therapy ; Endotoxins ; isolation & purification ; Female ; Hemoperfusion ; methods ; Polymyxin B ; Polystyrenes ; Rats ; Rats, Wistar

The mortality rate of acute paraquat (PQ) poisoning depends on the PQ concentration in the blood. It has been shown that the kidneys eliminate PQ effectively. However, early renal function deterioration is frequently observed in acute PQ intoxication. This study is designed to compare the efficacy of PQ elimination with hemoperfusion (HP) and kidneys, taking into account the functional deterioration of the kidneys. The amount of renal and HP excretion of PQ were measured during the procedure of HP in patients with acute PQ intoxication. The PQ clearance and the actual amount of PQ elimination by the HP cartridge during the HP procedure were 111+/-11 mL/min (range; 13.2-162.2 mL/min) and 251.4+/-506.3 mg (range; 4.6- 1,655.7) each. While, the renal clearance and actual amount of renal elimination of PQ was 79.8+/-56.0 mL/min (range; 9.7-177.0) and 75.4+/-73.6 mg (range; 4.9- 245.8). As the creatinine clearance decreased, the PQ elimination by HP was as effective as or more effective than the renal elimination. In conclusion, early HP must be provided for life saving treatment in patients with acute PQ intoxication.
Adult ; Aged ; Creatinine/blood ; Emergency Medicine/methods ; Female ; Hemoperfusion/*methods ; Herbicides/*poisoning ; Humans ; Kidney/drug effects/physiology ; Male ; Middle Aged ; Overdose/therapy ; Paraquat/*poisoning ; Renal Dialysis/*methods ; Suicide

The leukocytic phagocytosis rate and the index of phagocytosis of rats on cross-linked agar beads entrapped attapulgite clay (CAA) hemoperfusion were studied. The results revealed that the leukocytic phagocytosis rate and the index of phagocytosis descended significantly after 1 hour and rose gradually after 6 hours. Finally it reached the normal level after 48 hours. Hemoperfusion repeated two times gave similar results. In conclusion, the function of leukocytic phagocytosis declined temporarily during CAA hemoperfusion. Many times hemoperfusion will not notably affect the body's defense system of rats.
Agar ; Animals ; Biocompatible Materials ; Hemoperfusion ; methods ; Leukocytes ; drug effects ; physiology ; Magnesium Compounds ; Male ; Materials Testing ; Microspheres ; Phagocytosis ; drug effects ; Rats ; Rats, Wistar ; Silicon Compounds

OBJECTIVEIn China, with the development of public health and medical treatment, accident became the first cause of death of children aged form 1 to 14 years, and poisoning became one of the main causes. The present study was conducted to investigate the efficacy of hemoperfusion (HP) on poisoning, and the pharmacokinetics of the poison during and after HP. The study was also to observe the effect of HP on blood cell and blood biochemistry, blood flow and dosage of heparin during HP in children.

METHODSThirty-five children with acute poisoning (including 26 boys and 9 girls aged from 10 months to 13 years, mean 3.35 +/- 2.50 years) were treated with HP for one to three times. Among them 12 children were treated with HP for two times and 4 children for three times. Two ml blood samples of 6 children with Fluoroacetamide (FAM) poisoning and 10 children with Tetramine (TET) poisoning were collected. The concentration of poison was measured by gas chromatography (GC).

RESULTSThe poisoning symptoms of all cases were relieved or alleviated obviously. In the end, 27 (77%) cases recovered and 6 (17%) cases improved, while 2 (6%) cases died of multi-organ failure (MOF). Clinical symptom happened again 6 - 24 hours after HP in 1 case with FAM poisoning and 3 cases with TET whose clinical symptoms were relieved during HP. The PLT, RBC counts and Hb decreased significantly after HP compared with pre-HP (P < 0.05), while WBC, alanine aminotransferase (ALT), aspartate aminotransferase (AST), reatine kinase (CK), blood urea nitrogen (BUN), creatinine (CRE), Creatine kinase isoenzymes (CK-MB), total protein (TP), albumin (ALB) and globulim (GLO) after HP did not significantly change (P > 0.05). The FAM concentration was significantly reduced (P < 0.030). The concentration of TET in the poisoned children also significantly decreased with the treatment (P = 0.001). The cleaning efficacy of HP was higher during the first hour than that during the second hour of HP. The concentration of poison rose again 2 - 6 hours after HP in 1 case with FAM poisoning and 3 cases with TET poisoning, but the level was lower compared with pre-HP level. The t(1/2) of FAM and TET with and without HP was (2.40 +/- 0.66) h, (15.60 +/- 8.22) h, (4.10 +/- 1.66) h and (67.01 +/- 48.42) h, respectively. The first dose of heparin was (0.54 +/- 0.15) mg/kg; then (0.20 +/- 0.06) mg/kg was added for every 30 minutes. The velocity of blood flow was (4.39 +/- 0.99) ml/min.

CONCLUSIONSThe t(1/2) of the poison was shortened, and the poison clearing was accelerated by HP. The HP is a safe and effective therapy in children. The concentration of poison in some patient may rise again 2 to 6 hours after HP temporarily. The charcoal HP cannot remove the poison that conjugated with plasma albumin and globulin. The charcoal HP can cause temporary reduction of platelet and erythrocyte. The dosage of heparin used in children was lower than that in adult.

Blood Urea Nitrogen ; Charcoal ; therapeutic use ; Child, Preschool ; China ; Creatinine ; blood ; Female ; Hemoperfusion ; methods ; Humans ; Infant ; Male ; Multiple Organ Failure ; blood ; therapy ; Neonatology ; Poisoning ; blood ; therapy

OBJECTIVEIn the past the mortality and sequelae rate of the patients with severe fluoroacetamide (FAM) poisoning treated only with traditional remedies was high. During the recent ten years the authors treated children with severe FAM poisoning with charcoal hemoperfusion (HP) and achieved better results. However evidence was not sufficient to show that reduced mortality and sequelae rates were obtained from HP without traditional treatment because of lack of prospective randomized, controlled clinical studies. Thus, a dog model for FAM poisoning was designed in order to study the therapeutic effect, high-efficiency time of HP, the time of tissue-poisoning to release after HP, and to investigate the toxicokinetics of the poison in the course of treatment and after HP.

METHODFourteen dogs were given intraperitoneal FAM at a dose of 0.3 mg/kg body weight. HP was performed on 9 poisoned dogs for 30 - 120 minutes post intoxication. Each procedure lasted for 4 hours. Blood samples of the 9 poisoned dogs were collected before HP and 30, 60, 90, 120, 180, 240 minutes during HP and 2, 6, 24 hours after HP. Blood plasma was separated from blood samples and stored at -20 degrees C. The concentration of the poison was measured by gas chromatography (GC). The clinical symptoms of all the dogs were observed for one day.

RESULTSThe FAM concentration (ng/ml) of blood samples in poisoned dogs before HP, and 60, 120, 180, 240 minutes during HP were 230.11 +/- 52.48, 184.56 +/- 62.57, 141.00 +/- 44.83, 126.78 +/- 61.04, 113.11 +/- 54.65 respectively. The differences were significant (chi(2) = 31.978, P < 0.0005). The dispersion count between pre-HP and HP for 1 was 45.55, between 1 h and 2 h was 43.56, between 2 h and 3 h was 14.22 and between 3 h and 4 h was 13.67. The values of FAM had declined by 38.7%, 45.0% and 50.8% respectively at 2 h, 3 h, 4 h of HP compared with pre-HP. The rate of cleaning efficacy of FAM of every hour during HP were 19.79%, 23.6%, 10.09% and 10.78% respectively during HP 1, 2, 3, 4 h. The cleaning efficacy of HP was high within 2 hours during HP. The concentration of FAM slightly rose again 6 h after HP. The level of FAM had declined at 24 hour after HP when compared with pre-HP level. The reduction rate of FAM level for every hour during HP was higher than that after HP (12.71% vs 0.27% - 2.22%). The t(1/2) of FAM with and without HP were (4.50 +/- 1.20) h and (49.60 +/- 10.56) h. All the 5 poisoned dogs not treated with HP died. However 6 poisoned dogs treated with HP kept alive after HP. Three dogs had frequent seizures again 4h after HP. After HP the charcoal container was washed by 0.9% saline and FAM could not be detected in the douche.

CONCLUSIONSCharcoal HP was an effective treatment for severe FAM poisoning. T(1/2) of the poison was shortened, and the poison clearing rate was accelerated by HP. The high-efficiency time of HP was 2 - 2.5 h. Activated charcoal can adsorb the poison vigorously, and return of blood to the body after HP by using 0.9% saline was feasible and safe.

Animals ; Charcoal ; therapeutic use ; Dogs ; Fluoroacetates ; poisoning ; Hemoperfusion ; methods ; Metabolic Clearance Rate ; Poisoning ; metabolism ; therapy ; Poisons ; toxicity ; Seizures ; chemically induced ; Treatment Outcome