Filtration analysis of blood microemboli is not significantly affected by pulsatile filtration pressure and by pyrolite carbon filters

Detection of microemboli by constant-pressure filtration during in vitro circulation of bovine and human blood

The constant-pressure filtration (CPF) method has been developed to assess blood microemboli (BME) in terms of their ability to occlude microvascular flow. Previous reports suggest that the method is sensitive to the effects of platelet stimulation and to blood-pumping conditions. BME production and heparin activity were studied in bovine and human blood pumped by a Pellethane ventricle with Pellethane molded valves connected via smooth quick-connects to a Pellethane horseshoe-shaped reservoir. In each experiment, blood was collected into heparin by cardiac puncture from a stunned animal or by venepuncture from a human donor. The blood from each donor was filled into three ventricle-reservoir systems (50 cc ventricle and 1,500 cc reservoir for the bovine blood, and 20 cc ventricle and 150 cc reservoir for the human blood). One of the systems received aspirin (ASA; 25 mg/dl) shortly after the onset of pumping, whereas the other two served as pumping and non-pumping controls. The blood was pumped in a full-fill/full-eject mode for up to 10 h. BME concentration was measured by the CPF method in which the blood was filtered through 20-microns pore filters at 20 mm Hg for 10 s, and the flowrate curves were evaluated from occlusion model. Heparin activity was measured by the activated partial thromboplastin time (APTT) test. In the early period after the onset of pumping, the BME concentration increased, whereas the APTT decreased from an initial value of greater than 250 s, with the relative rate of change for both the BME and the APTT being the following: pumping control greater than pumping ASA blood greater than quiescent control.(ABSTRACT TRUNCATED AT 250 WORDS)

Loss of anticoagulant effect of heparin during circulation of human blood in vitro

Device-induced thrombogenesis was studied in an in vitro model using human blood circulated through an artificial ventricle. A new constant pressure filtration technique was used to detect circulating microemboli, the activated partial thromboplastin time (APTT) test was used to monitor the blood for the presence of anticoagulant activity of heparin, and hemolysis was quantified by measuring the plasma free hemoglobin level. Circulation of blood through a 20-ml stroke volume pneumatically driven ventricle for 6-9 h resulted in a significant reduction of APTT, indicating the loss of the anticoagulant effect of heparin. Microemboli concentration was minimal until the APTT decreased below 125 s, at which time the microemboli concentration increased rapidly. This was presumed to be due to the formation of thrombi following a decrease in heparin activity. A significant increase in hemolysis was also noted when blood was pumped. None of these changes was noted in the nonpumped control blood. Spontaneous loss of heparin activity in blood circulated by a pneumatically driven pump may have clinical implications and may help understanding of the problems associated with device-induced thrombogenesis.

Correlation between chemical stimulation and filtration flow resistance in human platelet aggregates

Human platelet-rich plasma (PRP) was aggregated with ADP to produce varying degrees of reversibility and platelet release, and then the chemical stimulation (as evidenced by optical transmittance) was compared with the flow resistance of physiologically-significant microaggregates, determined by constant-pressure filtration. The aggregate flow resistance was attributed to "weak" aggregates (which occluded the micropore filter at 20 mm Hg but which passed through the filter at 80 mm Hg) and "strong" aggregates (which occluded the filter at 80 mm Hg). As the ADP concentration was increased from 1 microM to 10 microM, the flow resistance of both the "weak" and "strong" aggregates generally increased, as did the maximum transmittance. No consistent trend was seen as the time after ADP addition increased from 5 to 30 minutes. Pretreatment of the PRP with epinephrine increased the maximum transmittance during ADP aggregation, produced less-reversible aggregates (less subject to deaggregation by PGE1), and increased the aggregate flow resistance over the range of filtration pressures tested. The addition of PGE1 to the aggregated sample before filtration nearly eliminated the flow resistance of the aggregates at all filtration pressures tested and partially reversed the optically-apparent aggregation. Pretreatment of PRP with PGE1 before epinephrine or ADP addition inhibited both the optically-detected aggregation and the development of flow resistance. The physical (hydrodynamic) strength of platelet aggregates is apparently related to the chemical stimulation of the release reaction and to aggregation irreversibility, possibly through the mediation of adenylate cyclase and cyclic AMP.