Semipermeable medical membranes

In this Section, it is implicitly assumed that the mass transport resistance at the fluid-membrane interface on either side of the membrane is negligible. Also the following is information that is made available publicly by the membrane manufacturers, when not otherwise noted. As in technical processes, mass transport across semipermeable medical membranes is conveniently related to the concentration and pressme driving forces according to irreversible thermodynamics. Hence, for a two-component mixture the solute and solvent capacity to permeate a semipermeable membrane under an applied pressure and concentration gradient across the membrane can be expressed in terms of the following three parameters Lp, hydraulic permeability Pm, diffusive permeability and a, Staverman reflection coefficient (Kedem and Katchalski, 1958). All of them are more accurately measured experimentally because a limited knowledge of membrane stmcture means that theoretical models provide rather inaccurate predictions. 

Thermoplastic synthetic polymers are used for preparing semipermeable medical membranes owing to their good mechanical resistance and low density, which make it possible to easily prepare thin self-supporting hollow-fiber membranes, and their low energy requirement and processing costs. In the following, the main features of the commercial semipermeable medical membranes made of synthetic polymers are briefly discussed. 

The first membranes used in medicine were made of cellophane, a ceUulose-based material that was used at that time as sausage casing (Kolff and Berk, 1943). To take advantage of the physical strength of cellulose membranes, but to improve on their diffusive permeability and biocompatibUity, techniques have been developed over the years to produce cellulose-based membranes with walls as thin as 5 p.m and featuring microdistrib-uted hydrophobic side branches. Below, the main features of the commercial semiperme-able medical membranes with a ceUulosic backbone are briefly discussed. 

Adsorbents are used in medicine mainly for the treatment of acute poisoning, whereas other extracorporeal techniques based on physico-chemical principles, such as dialysis and ultrafiltration, currently have much wider clinical applications [1]. Nevertheless, there are medical conditions, such as acute inflammation, hepatic and multi-organ failure and sepsis, for which mortality rates have not improved in the last forty years. These conditions are usually associated with the presence of endotoxin - lipopolysaccharide (LPS) or inflammatory cytokines - molecules of peptide/protein nature [2]. Advantages of adsorption over other extracorporeal techniques include ability to adsorb high molecular mass (HMM) metabolites and toxins. Conventional adsorbents, however, have poor biocompatibility. They are used coated with a semipermeable membrane of a more biocompatible material to allow for a direct contact with blood. Respectively, ability of coated adsorbents to remove HMM solutes is dramatically reduced. In this paper, preliminary results on adsorption of LPS and one of the most common inflammatory cytokines, TNF-a, on uncoated porous polymers and activated carbons, are presented. The aim of this work is to estimate the potential of extracorporeal adsorption technique to remove these substances and to relate it to the porous structure of adsorbents. 

Figure 8.34 Examples of drug-delivery systems employing polymeric membranes, (o) Ocusert system for the eye with two rote-controlling membranes, (b) Tronsiderm system for transdermal medication with one rote-controlling layer, (c) The Progestasert device for intrauterine insertion in which the body of the device serves as the rote-controlling barrier, (d) The oral Oros device in which the membrane is o semipermeable membrane which forbids drug transport, allowing water ingress only.

Semipermeable membranes play important roles in the normal functioning of many living systems. In addition, they are used in a wide variety of industrial and medical applications. Membranes with different permeability characteristics have been developed for many different purposes. One of these is the purification of water by reverse osmosis. 

Polyurethane hydrogels are widely used in soft contact lenses, controlled release devices, semipermeable membranes and hydrophilic coatings (66). The properties of polyurethane hydrogels can be varied by variation of their components, such as the polyols, diisocyanate, chain extender, or cross-linker (67-69). Because of the excellent mechanical and physical properties, polyurethanes are widely used in medical applications such as coating for medical devices for preventing protein adsorption (70, 71). 

HoUow fibers are widely used for filtration, utilizing the semipermeable nature of their capillary walls. In the medical industry, hollow fiber bioreactors are often made from cellulose and synthetic polymers. Cellulose acetate and cuprammonium rayon are the widely used ceUulose-based hollow fibers, while synthetic hollow fibers are often made from polysulfone, polyamide, and polyacrylonitrile. Modifications can be made to these materials to improve their functions by using polymers based on phospholipid, a substance found in the human cell membrane. 2-methaCTyloyloxyethyl phosphoryl-choline (MPC) is a methacrylate monomer with a phospholipid polar group. When MPC-based copolymers are used as additives for polysulfone, protein adsorption and platelet adhesion can be effectively reduced, thereby improving blood compatibility. Cellulose acetate hollow fiber membranes can also be modified with MPC-based copolymers by means of blending or surface coating to obtain improved permeability. 

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