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Hemostatic Changes Induced In Vitro by Hemoperfusion Over Activated Charcoal

1978; Wiley; Volume: 2; Issue: 3 Linguagem: Inglês

10.1111/j.1525-1594.1978.tb03468.x

1525-1594

James F. Winchester, John M. Mackay, Charles D. Forbes, J.M. Courtney, T. Gilchrist, Colin R.M. Prentice,

Burn Injury Management and Outcomes

ABSTRACT The effect of hemoperfusion over charcoal on changes in platelet counts, coagulation factor concentrations and standard coagulation tests were determined during a two‐hour in vitro perfusion of normal blood through a column containing 20 gm of activated charcoal, either uncoated or coated with 0.5% acrylonitrile/dimethylaminoethyl methacrylate copolymer (AN/DMAEMA). With citrated whole blood, platelet counts fell by 15% during hemoperfusion over coated or uncoated charcoal and also during passage through an identical empty chamber. On the other hand, with heparinized whole blood, platelet counts fell by 90% during hemoperfusion over uncoated charcoal, and 25% during hemoperfusion over coated charcoal. The concentrations of coagulation factors II, V, IX, X and XII were reduced during hemoperfusion over uncoated charcoal, while those of factors II and X were reduced and that of factor VII increased during hemoperfusion over coated charcoal. Perfusion with heparinized, platelet‐rich plasma resulted in small reductions in platelet counts, suggesting that either erythrocyte disruption or the physical effects of intact red cells play a major role in producing the hemostatic abnormalities occurring during whole blood hemoperfusion. The method described may be used to assess the hemocompatibility of polymer coatings for charcoal particles, to investigate the nature of the interaction between platelets and artificial surfaces, and to assess the effect of platelet‐active agents in reducing platelet adsorption on charcoal or other sorbents.