Novel method for estimating the total blood volume: the importance of adjustment using the ideal body weight and age for the accurate prediction of haemodilution during cardiopulmonary bypass

Muraki, Ryosuke; Hiraoka, Arudo; Nagata, Kazuyuki; Nakajima, Kiyokazu; Oshita, Tomoya; Arimichi, Masahisa; Chikazawa, Genta; Yoshitaka, Hidenori; Sakaguchi, Taichi

doi:10.1093/icvts/ivy173

Cited by 23 publications

(13 citation statements)

References 18 publications

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“…The Ht was adjusted to different levels, ranging from 2 to 45%. This range was selected to cover the typical haematocrit values in oxygenators which vary between 18 and 37%, since various haemodilution steps can be used during cardiopulmonary bypass 18 . The Ht range was extended to lower values in our experiments for completeness.…”

Section: Methodsmentioning

confidence: 99%

Haematocrit heterogeneity in blood flows past microfluidic models of oxygenating fibre bundles

Bardón

Passos

Piergiovanni

et al. 2019

Medical Engineering & Physics

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Blood oxygenators act as an extracorporeal artificial lung during certain types of cardiac surgery and intensive care therapies. Inside these devices, blood is forced to flow across an oxygenating bundle, encountering interstitial gaps comparable to those typical of the microvasculature. Despite the wellknown effects of such length scales on haemorheology and red blood cell (RBC) behaviour, these are generally overlooked in oxygenator modelling and design; it is persistently assumed that RBCs are homogeneously distributed throughout the oxygenating bundle, independently of their microstructure arrangement or main flow directions. The goal of this study is to provide preliminary experimental evidence of heterogeneous RBC distributions inside oxygenating fibre bundles. To this end, a number of microchannels were manufactured inspired by actual oxygenating devices, considering simplified versions of their microstructure. These comprise staggered arrays of micro pillars, which were perfused with RBC suspensions, with feed haematocrit (Ht) and velocities relevant for clinical use. The microchannels were imaged using a microscope and high-speed camera to accurately capture cell distribution. The imaged blood flows revealed the non-uniform nature of RBC distributions in the arrays, characterised by local Ht gradients particularly around the O2 sources inside the bundle. These heterogeneous distributions should be accounted for during oxygenator design, as RBC concentration plays a key role in O2 transport and, ultimately, overall device performance

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Section: Methodsmentioning

confidence: 99%

Haematocrit heterogeneity in blood flows past microfluidic models of oxygenating fibre bundles

Bardón

Passos

Piergiovanni

et al. 2019

Medical Engineering & Physics

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“…It usually takes 7 to 10 days to clean 90% of the accumulated toxins from the patient's plasma in a slowly accumulating antibody or toxin. 91,92,96 We can achieve a decline of almost 70% after three exchanges of one plasma volume. 91,97,98 The large multicentric study by Larsen and colleagues performed a high-volume strategy with exchange volumes of 9.3 AE 1.3 L. 26 They arbitrarily chose the above strategy.…”

Section: Prescription For Therapeutic Plasma Exchange: Deciding the Exchange Volume And Intensitymentioning

confidence: 95%

“…Therefore, increasing the exchange volumes beyond 1.5 is associated with a decline in the clearance of the targeted substances. 91,92,96 After each session, there is almost always a rebound increase in the removed substances. There are increased synthesis and a slow equilibration between the intravascular and extravascular compartments.…”

Section: Prescription For Therapeutic Plasma Exchange: Deciding the Exchange Volume And Intensitymentioning

confidence: 99%

“…The liver has a unique potential to regenerate, and there is a lack of pathogenic autoantibodies compared with other immune-mediated conditions. [91][92][93][94][95][96] TPE can clear the proinflammatory cytokines; however, at the same time, it nonselectively also removes the beneficial growth factors and anti-inflammatory cytokines predisposing the patients to infections and secondary organ failures. There are limited studies in patients with liver failure evaluating the ideal exchange volume and intensity of therapy.…”

Section: Prescription For Therapeutic Plasma Exchange: Deciding the Exchange Volume And Intensitymentioning

confidence: 99%

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Plasma Exchange in Acute and Acute on Chronic Liver Failure

Maiwall

Sarin

2021

Semin Liver Dis

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Liver failure in the context of acute (ALF) and acute on chronic liver failure (ACLF) is associated with high mortality in the absence of a liver transplant. For decades, therapeutic plasma exchange (TPE) is performed for the management of immune-mediated diseases. TPE has emerged as an attractive extracorporeal blood purification technique in patients with ALF and ACLF. The basic premise of using TPE is to remove the toxic substances which would allow recovery of native liver functions by facilitating liver regeneration. In recent years, encouraging data have emerged, suggesting the benefits of TPE in patients with liver failure. TPE has emerged as an attractive liver support device for the failing liver until liver transplantation or clinical recovery. The data in patients with ALF suggest routine use of high-volume TPE, while the data for such a strategy are less robust for patients with ACLF.

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“…Severe depletion of quantity leads to selective vasoconstriction masking Science over the past century, study has introduced different techniques for estimating blood volume [14]. So the scheme that can assist offer an precise assessment of blood quantity in the human body needs to be implemented [2].…”

Section: Introductionmentioning

confidence: 99%

Measurement of Circulation of Blood Volume(CBV) and Total Blood Volume(TBV) in Heart using Doppler Color Flow Imaging in Ultrasound Videos

Khairkar*,

Annadate

2019

IJITEE

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Total blood volume (TBV) analysis is key to manage the patients with cardiopulmonary bypass (CPB) cardiac surgery. Circulation of blood volume (CBV) is essential because the processes that maintain the connection between red cell volume (RCV), plasma volume (PV) and CBV may not be measured. The differences in significant surgery in patients do not always work efficiently and changes in CBV and need intensive care. The visible physiological clinical shock require urgent methods to regulate CBV because the current method is complicated and involves intervention. The current approaches to estimating blood quantity are labor-intensive, complex, and time-consuming. Severe depletion of quantity leads to selective vasoconstriction masking. Last decade, science has introduced different techniques for estimating blood quantity. So the scheme that can offer a precise assessment of blood quantity in the human body needs to be implemented. In this paper, a system is proposed where color flow imaging is used to measure TBV and CBV. The videos used are Doppler 2d echocardiogram which shows the color Doppler flow in the heart. The method used in this paper can be an alternative to the present methods of calculating the TBV and CBV as it is easy to measure the parameters with the help of Doppler velocity.

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Novel method for estimating the total blood volume: the importance of adjustment using the ideal body weight and age for the accurate prediction of haemodilution during cardiopulmonary bypass

Abstract: The conventional formula is unable to predict the actual haemodilution rate accurately. Our new formula with a combination of the ideal BW and adjustment for age was shown to be useful for the accurate prediction of the haemodilution rate during CPB.

Cited by 23 publications

References 18 publications

Haematocrit heterogeneity in blood flows past microfluidic models of oxygenating fibre bundles

Haematocrit heterogeneity in blood flows past microfluidic models of oxygenating fibre bundles

Plasma Exchange in Acute and Acute on Chronic Liver Failure

Measurement of Circulation of Blood Volume(CBV) and Total Blood Volume(TBV) in Heart using Doppler Color Flow Imaging in Ultrasound Videos

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