In vitro and in vivo testing of stereolithography (SLA)-manufactured haemocompatible photopolymers for blood pump

A major medical problem of state-of-the-art heart ventricular assist devices (LVADs) is device-induced thrombus formation due to inadequate blood-flow dynamics generated by the blood pump rotor. The latter is a highly complex device, with difficulties during conventional manufacturing through milling or casting. Therefore, the additive manufacturing technology relying on stereo-lithography (SLA) capable of producing parts of significantly increased freedom for a blood-flow-compatible, thrombus-risk-free design was chosen as novel and flexible technology for that type of application. However, as yet state-of-the-art SLA is not suitable to produce fully safe blood-contacting devices. Therefore, the present experiment covered chemical, mechanical, rheological, tribological, and complex biocompatibility characterization in accordance with i.a. ISO 10993 standards, including hemolysis and an acute thrombogenicity blood test on fresh animal blood (both as innovative laboratory tests to avoid animal usage in preclinical studies) with a special focus on testing demonstrators of miniaturized blood pump rotors. The conducted tests indicated acceptable biocompatibility of the material and a slight improvement in biocompatibility with surface modification. Additionally, a high biocompatibility of the tested materials was confirmed. Based on studies and simulations, stereolithography (SLA) as an additive manufacturing technology with significantly increased freedom for a blood-flow-compatible, thrombus-risk-free design was chosen as a novel and flexible technology basis in the 4DbloodROT project to enable future manufacturing of rotors with exceptional biomimetic complexity

Acute coronary ischemia during alcohol withdrawal: a case report

<p>Abstract</p> <p>Introduction</p> <p>The potential of alcohol withdrawal to cause acute coronary events is an area that needs the urgent attention of clinicians and researchers.</p> <p>Case presentation</p> <p>We report the case of a 52-year-old heavy-alcohol-using Sri Lankan man who developed electocardiogram changes suggestive of an acute coronary event during alcohol withdrawal. Despite the patient being asymptomatic, subsequent echocardiogram showed evidence of ischemic myocardial dysfunction. We review the literature on precipitation of myocardial ischemia during alcohol withdrawal and propose possible mechanisms.</p> <p>Conclusions</p> <p>Alcohol withdrawal is a commonly observed phenomenon in hospitals. However, the number of cases reported in the literature of acute coronary events occurring during withdrawal is few. Many cases of acute ischemia or sudden cardiac deaths may be attributed to other well known complications of delirium tremens. This is an area needing the urgent attention of clinicians and epidemiologists.</p

Noninvasive acoustic blood volume measurement system for the POLVAD prosthesis

The following paper presents researches concerning a noninvasive real-time blood volume measurement system applied in POLVAD prosthesis. The system is based on the acoustic Helmholtz resonator principle. The basis of the measurement method, followed by the preliminary tests of the possibility of incorporating the Helmholtz resonance idea into the POLVAD prosthesis is shown. The paper includes the actual measurement system construction and test results, both static and dynamic obtained at the Foundation for Cardiac Surgery Development in Zabrze, Poland. Conclusions and future plans are presented too

Analysis of actual accuracy in cardiac output measurements by means of thermodilution

The essential examination in hemodynamic monitoring of the patient is the cardiac output (CO) measurement. Nowadays, in clinical practice the most popular method is indicator dilution, particularly thermodilution. It is realized by applying the Swan-Ganz catheter and observing changes of the indicator concentration. This method is sensitive to many factors and the obtained results should be treated cautiously. The paper presents theoretical and experimental studies of metrological phenomena in CO measurements by means of thermodilution, paying special attention to medical aspects of the measurements. It has been pointed out that the actual unreliability of the mentioned method reaches values from 20% to 45%, which is in opposition to the technical data of patient's monitors (typical accuracy about 5%)

The influence of limited dynamic response of the indicator detector in a Swan-Ganz catheter on the overestimation of cardiac output measurement by means of thermodilution

Nowadays the "gold clinical standard" of hemodynamics diagnostic and cardiac output measurements is pulmonary artery catheterization by means of the Swan-Ganz catheter and thermodilution. The method itself is sensitive to numerous disturbances which cause inaccurate results. One of the well-known disadvantages of thermodilution is the overestimation of results at low values of cardiac output. This effect may concern the limited slew rate of the thermoelement mounted at the tip of the catheter. In this paper the relationship between the dynamic response of the thermoelement and the uncertainty of cardiac output measurements by means of thermodilution has been investigated theoretically and experimentally

The Influence of Limited Dynamic Response of the Indicator Detector in a Swan-Ganz Catheter on the Overestimation of Cardiac Output Measurement By Means of Thermodilution

Nowadays the "gold clinical standard" of hemodynamics diagnostic and cardiac output measurements is pulmonary artery catheterization by means of the Swan-Ganz catheter and thermodilution. The method itself is sensitive to numerous disturbances which cause inaccurate results. One of the well-known disadvantages of thermodilution is the overestimation of results at low values of cardiac output. This effect may concern the limited slew rate of the thermoelement mounted at the tip of the catheter. In this paper the relationship between the dynamic response of the thermoelement and the uncertainty of cardiac output measurements by means of thermodilution has been investigated theoretically and experimentally

Physical Model of the Pulmonary Circulation Designed for Investigation on Cardiac Output Measurement by Means of the Thermodilution Method

The "gold clinical standard" of cardiac output measurements is the thermodilution method, implemented by the Swan-Ganz catheter. The unreliability of obtained results is difficult to estimate experimentally, due to the lack of reference methods or the risk of serious interferences in the measured object. Moreover, the pulsating blood flow produced by the heart is difficult to measure. Therefore it is advisable to develop the physical model of the pulmonary circulation, designed to investigate the accuracy of cardiac output measurements by means of the thermodilution method

Sculptures du temple de Baalshamin à Palmyre (les)

Gawlikowski Michel, Pietrzykowski M. Sculptures du temple de Baalshamin à Palmyre (les). In: Syria. Tome 57 fascicule 2-4, 1980. pp. 421-452