In vitro investigation of a new thrombus aspiration and autologous blood reinfusion system

Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyvinyl chloride(PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12 F aspiration catheters were used to aspirate the thrombus in the right–pulmonary-artery model, 8 French and 14 F aspiration catheters were used in the inferior–vena cava model, and 8 French and 10 F aspiration catheters were used in the left-–iliofemoral-vein model. A thrombus filtration and auto-blood reinfusion bottle was used to filter the thrombus and re-infuse auto-blood. We evaluated the thrombus aspiration capability of each catheter by comparing preaspirated with the post-aspirated thrombus volume, and we evaluated the difference in aspiration capability between the two catheters in each model by comparing their thrombus aspiration rates. We used Student’s t-test for statistical analysis.Results: Differences between pre-aspirated and post-aspirated thrombus volumes for each catheter were insignificant, as were those between the thrombus aspiration rates of the two catheters in each venous model. Using the thrombus aspiration and auto-blood reinfusion system, each aspiration catheter could fluently aspirate the thrombus out of the venous model.Conclusion: In this study, we designed a new venous-thrombus aspiration system. This system could be used to aspirate acute venous thrombi and re-infuse autologous blood.

Application of Succus Entericus Reinfusion in a Patient with Rectal Cancer and Jejunal Diverticulum: A Case Report and Literature Review

We herein report the case of a patient with rectal adenocarcinoma who underwent low anterior resection in our hospital. The patient experienced general peritonitis, septic shock, and ardent fever on postoperative day 3. An exploratory operation revealed a perforated proximal jejunal diverticulum.The patient then underwent total parenteral nutrition and succus entericus reinfusion. The metabolic disturbances and cacotrophy rapidly improved after reinfusion of intestinal secretions, and the patient was successfully cured without requiring a prolonged period of parenteral nutrition. Our data support the saying “If the gut is working, use it.” Our report also confirms the value of succus entericus reinfusion in the successful treatment of a spontaneous perforation of Meckel’s diverticulum after low anterior resection of the rectum.

Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen:A case report

Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.

Drainage of ascites in cirrhosis

For cirrhotic refractory ascites,diuretics combined with albumin and vasoactive drugs are the first-line choice for ascites management.However,their therapeutic effects are limited,and most refractory ascites do not respond to medication treat-ment,necessitating consideration of drainage or surgical interventions.Con-sequently,numerous drainage methods for cirrhotic ascites have emerged,including large-volume paracentesis,transjugular intrahepatic portosystemic shunt,peritoneovenous shunt,automated low-flow ascites pump,cell-free and concentrated ascites reinfusion therapy,and peritoneal catheter drainage.This review introduces the advantages and disadvantages of these methods in different aspects,as well as indications and contraindications for this disease.

Observation on the Efficacy of Autologous Blood Transfusion Combined with Controlled Hypotension in Patients with Spinal Internal Fixation during the Outbreak of New Coronavirus Pneumonia in Western Guangxi (in Guixi)

Objective: To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. Methods: 30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. Results: 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). Conclusion: During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.

Analysis on hidden blood loss of total knee arthroplasty in treating knee osteoarthritis

Background Total knee arthroplasty （TKA） is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin （HB） counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis.