BACKGROUND: Platelets (PLTs) stored in platelet additive solution (PAS) presents potential benefits in clinical use by reducing the risk of several plasma-associated adverse transfusion reactions and more plasma may be recovered for fractionation. In this study, we compared in vitro characteristics of apheresis PLTs stored in CompoSol PS (Fenwal, Lake Zurich, IL, USA), InterSol (Fenwal, Lake Zurich, IL, USA), SSP+ (MacoPharma, Tourcoing, France), T-PAS+ (Terumo BCT, Lakewood, CO, USA), or plasma to evaluate the effectiveness of PAS. METHODS: PLTs were collected two times by apheresis from 12 healthy volunteers in a study comparing four kinds of PASs with 35% autologous plasma and 100% plasma-stored apheresis PLTs. The parameters of PLTs, including PLT counts, pH, PLT activation markers, blood gases, and metabolic variables were assessed up to 7-day. RESULTS: The results of in vitro assay including PLT concentration, mean PLT volume, pH, and blood gases for PLTs in four kinds of PASs were similar to those in 100% plasma PLTs. All units had Day 5 pH greater than 6.2. In vitro quality rating results, PLTs in T-PAS+ had a rating of 5, 4 for CompoSol PS, 2 for SSP+, 1 for InterSol, and 2 for plasma on Day 5. CONCLUSION: Partial replacement of plasma with CompoSol PS, SSP+, or T-PAS+ in PLTs showed better or equivalent quality and preservability of PLTs compared to PLTs in 100% plasma. The use of PAS for storage of PLTs in clinical practice may have an advantage as PAS-stored PLTs have a reduced volume of plasma.
Blood Component Removal* ; Blood Group Incompatibility ; Blood Platelets* ; Gases ; Healthy Volunteers ; Hydrogen-Ion Concentration ; Lakes ; Plasma

PURPOSE: We aimed to investigate the cardiopulmonary effects of pressurized cement insertion in elderly patients undergoing cemented hip hemiarthroplasty. MATERIALS AND METHODS: We conducted a randomized prospective study on elderly patients undergoing cemented hip hemiarthroplasty. Patients were divided into pressurized and non-pressurized groups based on the pressure application during cement insertion. We measured mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), arterial blood gases and serotonin concentration in blood. These variables were measured before bone cement insertion, and 3 and 5 minute after insertion. They were also measured immediately and 15 minutes after reduction. RESULTS: In cemented hip hemiarthroplasty, there were no significant change in MAP (P=0.92), SBP (P=0.85), DBP (P=0.98), HR (P=0.97) and serotonin concentration over time. There were no statistically significant difference between the two groups in MAP, SBP, DBP, HR, PO2, PaCO2, SaO2 and serotonin concentration, though three minutes after cement insertion, both groups showed decreases in SBP, DBP and MBP. CONCLUSION: The pressurization method in cemented hip hemiarthroplasty was not found to be related with development of bone cement syndromes in elderly patients.
Aged ; Arterial Pressure ; Blood Pressure ; Gases ; Heart Rate ; Hemiarthroplasty* ; Hip* ; Humans ; Prospective Studies* ; Serotonin

BACKGROUND: If acid-base status and electrolytes on blood gases during cardiopulmonary resuscitation (CPR) differ between the arrest causes, this difference may aid in differentiating the arrest cause. We sought to assess the ability of blood gases during CPR to predict the arrest cause between primary cardiac arrest and asphyxial arrest. METHODS: A retrospective study was conducted on adult out-of-hospital cardiac arrest patients for whom blood gas analysis was performed during CPR on emergency department arrival. Patients were divided into two groups according to the arrest cause: a primary cardiac arrest group and an asphyxial arrest group. Acid-base status and electrolytes during CPR were compared between the two groups. RESULTS: Presumed arterial samples showed higher potassium in the asphyxial arrest group (p < 0.001). On the other hand, presumed venous samples showed higher potassium (p = 0.001) and PCO2 (p < 0.001) and lower pH (p = 0.008) and oxygen saturation (p = 0.01) in the asphyxial arrest group. Multiple logistic regression analyses revealed that arterial potassium (OR 5.207, 95% CI 1.430-18.964, p = 0.012) and venous PCO2 (OR 1.049, 95% CI 1.021-1.078, p < 0.001) were independent predictors of asphyxial arrest. Receiver operating characteristic curve analyses indicated an optimal cut-off value for arterial potassium of 6.1 mEq/L (sensitivity 100% and specificity 86.4%) and for venous PCO2 of 70.9 mmHg (sensitivity 84.6% and specificity 65.9%). CONCLUSIONS: The present study indicates that blood gases during CPR can be used to predict the arrest cause. These findings should be confirmed through further studies.
Adult ; Asphyxia ; Blood Gas Analysis ; Cardiopulmonary Resuscitation ; Electrolytes ; Emergencies ; Gases ; Hand ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Logistic Models ; Out-of-Hospital Cardiac Arrest ; Oxygen ; Potassium ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

OBJECTIVETo evaluate the hemocompatibility of a small-caliber expanded polytetrafluoroethylene vessel with silk fibroin coating sulfonated by low temperature plasma treatment.

METHODSThe composite blood vessel was prepared by first coating the small-caliber expanded polytetrafluoroethylene vessel with silk fibroin followed by sulfonation by low temperature plasma treatment. After hemolysis test in vitro, dynamic coagulation time test, blood platelet adhesion test, and recalcification time test were performed to evaluate the hemocompatibility of the composite blood vessel.

RESULTSScanning electronic microscopy revealed obvious platelets adhesion on the conventional artificial (control) vessel, which seldom occurred on the composite vessel. The curve of absorbance-clotting time of the composite vessel declined more slowly than that of the control vessel. The recalcification time of the composite blood vessel averaged 603 s, significantly longer than that of the control vessel (480 s, P = 0.000).

CONCLUSIONThe composite blood vessel has good antithrombotic activity and hemocompatibility as a promising vascular prosthesis.

Blood Vessel Prosthesis ; Coated Materials, Biocompatible ; chemistry ; Cold Temperature ; Fibroins ; chemistry ; Humans ; Materials Testing ; Plasma Gases ; Polytetrafluoroethylene ; chemistry ; Sulfonic Acids ; chemistry

OBJECTIVE:To test the efficacy and safety of PhilVent™, a pressure limited, time cycled, Philippine ventilator through animal and clinical studies.
METHODS AND RESULTS:
Animal study: Term, newborn piglets (N=8) were intubated and alternately cycled to the PhilVent™ or to a pressure limited, time cycled, commercial ventilator (Sechrist) at peak inspiratory pressures of 10, 13 and 15 cm H20 and rates of 15, 20, 25 breaths per min and constant FiO2 (0.40) and positive end expiratory pressure (+4). Blood gases and adverse events (pneumothorax, sudden deterioration, death) were monitored. Results show no significant difference in blood gases on either machine at the various ventilator settings. No adverse events occurred.
Clinical study: Prospective, randomized, controlled trial of 90 preterm infants with respiratory distress, randomized either to PhilVent™ (N=45) or Sechrist (N=45). Ventilator settings were adjusted to achieve predetermined range of blood gases. Arterial blood gases and any adverse events e.g., pneumothorax, pulmonary hemorrhage were monitored. There were no clinically significant differences in the ventilator settings or blood gases of the infants on the PhilVent™ or Sechrist. No increase in adverse events were noted with the PhilVent™.
CONCLUSION: In animal and clinical studies, the efficacy and safety of the PhilVent were comparable to the Sechrist. The PhilVent™ is an effective, alternative ventilator for the treatment of respiratory insufficiency in newborn infants.

Animal ; Male ; Female ; Infant Newborn ; Animals ; Blood Gas Analysis ; Gases ; Infant, Newborn ; Infant, Premature ; Philippines ; Pneumothorax ; Positive-pressure Respiration ; Prospective Studies ; Respiratory Insufficiency ; Ventilators, Mechanical ; Respiratory Distress Syndrome, Newborn ; Respiratory Insufficiency ; Equipment And Supplies

BACKGROUND: To clarify the effect of hypoxia on vascular contractility, we tried to show whether hypoxia induced the release of endothelium-derived relaxing factor (EDRF) and the nature of the underlying mechanism for this release. MATERIAL AND METHOD: Isometric contractions were observed in rabbit aorta, and the released EDRF from the rabbit aorta was bioassayed by using rabbit denuded carotid artery. The intracellular Ca2+ concentration ([Ca2+]i) in the cultured rabbit aortic endothelial cells was recorded by a microfluorimeter with using Fura-2/AM. Hypoxia was evoked to the blood vessels or endothelial cells by eliminating the O2 in the aerating gases in the external solution. Chemical hypoxia was evoked by applying deoxyglucose or CN-. RESULT: Hypoxia relaxed the precontracted rabbit thoracic aorta that had its endothelium, and the magnitude of the relaxation was gradually increased by repetitive bouts of hypoxia. In contrast, hypoxia-induced relaxation was not evoked in the aorta that was denuded of endothelium. In a bioassay experiment, hypoxia released endothelium-derived relaxing factor (EDRF) and the release was inhibited by L-NAME or the K+ channel blocker tetraethylammonium (TEA). In the cultured endothelial cells, hypoxia augmented the ATP-induced increase of the intracellular Ca2+ concentration ([Ca2+]i) and this increase was inhibited by TEA. Furthermore, chemical hypoxia also increased the Ca2+ influx. CONCLUSION: From these results, it can be concluded that hypoxia might induce the release of NO from rabbit aortic endothelial cells by increasing [Ca2+]i.
Anoxia ; Aorta ; Aorta, Thoracic ; Biological Assay ; Blood Vessels ; Carotid Arteries ; Deoxyglucose ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Gases ; Isometric Contraction ; NG-Nitroarginine Methyl Ester ; Nitrous Oxide ; Relaxation ; Tea ; Tetraethylammonium

BACKGROUND:This study was designed to compare hydroxyethylstarch (HES) to albumin in high-risk surgery patients infused over 72 h peri-operatively; hemodynamic changes, oxygen transport parameters, blood gases, blood coagulation, blood loss, blood use, outcome, and costs were compared. METHODS:High-risk surgical patients undergoing high-risk abdominal, cranial, and orthopaedic surgery were treated with 6% HES (130/0.4; n = 41) or 20% albumin (n = 19).The goal of volume therapy was to maintain a normal cardiac index (CI; 3.0 L/min/m2) over 72 h peri-operatively. RESULTS:The hemodynamic and cardiac effects of 6% HES were superior to 20% albumin.HES reduced disturbances in blood coagulation, blood loss, and blood use as compared to albumin. Volume therapy with HES and albumin improved patient outcomes.Use of HES resulted in a significant cost reduction compared to albumin. CONCLUSIONS:Volume replacement with 6% HES and 20% albumin in surgery over 72 h peri-operatively improved hemodynamic parameters and oxygen transport to normal values.HES provides a cost-effective alternative to albumin in surgery with improved efficacy and safety.
Blood Coagulation ; Gases ; Hemodynamics ; Humans ; Orthopedics ; Oxygen

BACKGROUND:This study was designed to compare hydroxyethylstarch (HES) to albumin in high-risk surgery patients infused over 72 h peri-operatively; hemodynamic changes, oxygen transport parameters, blood gases, blood coagulation, blood loss, blood use, outcome, and costs were compared. METHODS:High-risk surgical patients undergoing high-risk abdominal, cranial, and orthopaedic surgery were treated with 6% HES (130/0.4; n = 41) or 20% albumin (n = 19).The goal of volume therapy was to maintain a normal cardiac index (CI; 3.0 L/min/m2) over 72 h peri-operatively. RESULTS:The hemodynamic and cardiac effects of 6% HES were superior to 20% albumin.HES reduced disturbances in blood coagulation, blood loss, and blood use as compared to albumin. Volume therapy with HES and albumin improved patient outcomes.Use of HES resulted in a significant cost reduction compared to albumin. CONCLUSIONS:Volume replacement with 6% HES and 20% albumin in surgery over 72 h peri-operatively improved hemodynamic parameters and oxygen transport to normal values.HES provides a cost-effective alternative to albumin in surgery with improved efficacy and safety.
Blood Coagulation ; Gases ; Hemodynamics ; Humans ; Orthopedics ; Oxygen

BACKGROUND: ASV is a closed-loop ventilation system that guarantees a user-set minimum per-minute volume in intubated patients, whether paralyzed or with spontaneous breathing. Here, we tested the effects of ASV onrespiratory mechanics and compared them with volume-controlled ventilation (VCV). METHODS: Thirteen patients meeting the criteria for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) were enrolled. All patients were paralyzed to eliminate spontaneous breathing. We started with VCV (VCV1), then used ASV followed by VCV modes (VCV2), maintaining minute volume as much as that of VCV1. RESULTS: During ASV, compared with VCV1, the inspiratory and expiratory tidal volumes and expiratory resistance increased. Conversely, the total respiratory rate and maximum pressure decreased. No changes in the arterial blood gases, heart rate, or mean systemic pressure were noted during the trial. CONCLUSIONS: In ALI/ARDS patients, although no differences were observed in the arterial blood gas analysis between the two modes, ASV provided better respiratory mechanics in terms of peak airway pressure and tidal volume than VCV.
Acute Lung Injury ; Blood Gas Analysis ; Gases ; Heart Rate ; Humans ; Lung ; Mechanics ; Respiration ; Respiratory Mechanics ; Respiratory Rate ; Tidal Volume ; Ventilation

OBJECTIVEThe present study was designed to observe the plasma concentrations of hydrogen sulfide (H(2)S) and homocysteine (HCY) in hypertensive patients with different blood pressure levels and complications.

METHODSA total of 165 outpatients with essential hypertension were involved in this study (84 males, 81 females, mean age 59.81 +/- 10.60 years old). There were 28 new-onset untreated, 137 ever-treated patients. Among ever-treated patients, blood pressure was normal in 38, grade 1 hypertension in 43, grade 2 and 3 hypertension in 56 patients. Thirty-two patients were accompanied with coronary heart disease (CAD), and 42 patients were accompanied with stroke. A total of 32 age- and sex-matched healthy controls (18 males) were also recruited. Plasma H(2)S and HCY concentrations were determined in all patients and controls.

RESULTS(1) Plasma H(2)S levels were significantly lower (P < 0.05) and HCY levels were significantly higher (P < 0.01) in ever-treated hypertensive patients compared with controls. (2) Plasma HCY levels were significantly higher in patients with hypertension history > 6 months and complicated with CAD compared to patients without CAD. (3) Plasma H(2)S concentrations in patients with stroke history > 5 years were significantly lower than that in patients without stroke (P < 0.01). Plasma HCY concentrations were increased in proportion to stroke history. (4) In ever-treated hypertensive patients, plasma H(2)S concentrations in patients with grade 2 and 3 hypertension were significantly lower (P < 0.05) and HCY levels significantly higher (P < 0.01) than that in patients with well-controlled blood pressure.

CONCLUSIONHyperhomocysteinemia and the novel signaling gasotransmitter H(2)S might play important roles in the pathogenesis and development of hypertension.

Adult ; Aged ; Blood Pressure ; Case-Control Studies ; Female ; Gases ; blood ; Homocysteine ; blood ; Humans ; Hydrogen Sulfide ; blood ; Hypertension ; blood ; physiopathology ; Male ; Middle Aged ; Plasma ; chemistry