TITLE

Comparison of three oxygenator-coated and one total-circuit-coated extracorporeal devices

AUTHOR(S)
Baksaas, S.T.; Videm, V.; Pedersen, T.; Karlsen, H.; Mollnes, T.E.; Brosstad, F.; Svennevig, J.L.
PUB. DATE
March 1999
SOURCE
Perfusion;1999, Vol. 14 Issue 2, p119
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The present study was designed to compare the biocompatibility of three cardiopulmonary bypass setups with different surface coatings, and to determine if coating of the whole circuit with one of the coatings was more beneficial than coating of the oxygenator only. Extracorporeal devices entirely coated with synthetic polymers (Avecor,n = 6) were compared to oxygenators coated with synthetic polymers (Avecor, n = 6), end-point, covalently attached heparin (CBAS, n = 6) or absorbed heparin (Duraflo 2, n = 6) in an in vitro model of a heart–lung machine. The circuits were primed with fresh human whole blood and Ringer's acetate and recirculated at 4 l/min at 30°C for 2 h. Test samples were obtained at regular intervals and analysed for myeloperoxidase (MPO), platelet counts, β-thromboglobulin, heparin, prothrombin fragment 1+2, plasmin–anti-plasmin complexes, and complement activation products. The mean MPO concentrations increased in the Avecor-coated oxygenator group (AV) from 247 at the start to 671 mg/l at the termination of the experiments, in the Avecor-coated total circuit group (AV-T) from 116 to 288 mg/l, in the Duraflo 2 coated oxygenator group (DU) from 160 to 332 mg/l, and in the CBAS-coated oxygenator (CA) group from 172 to 311 mg/l. The MPO concentrations increased significantly in all groups (p < 0.03). The increase in group A was significantly higher than in the other three groups (p = 0.007). The mean platelet counts decreased in the Avecor-coated total circuit group from 117 at start to 99 × 109/l at termination of the experiments, in the Avecor-coated oxygenator group from 119 to 103 × 109/l, in the Duraflo 2 group from 96 to 86 × 109/l, and in the CBAS group from 132 to 123 × 109/l. The platelet counts decreased significantly in all groups (p < 0.01), but the intergroup differences were not significant (p = 0.15). The mean β-thromboglobulin concentrations increased in the Avecor-coated total circuit group from 193 at the start to 754 ng/ml at the termination of the experiments, in the Avecor-coated oxygenator group from 474 to 1654 ng/l, in the Duraflo 2 group from 496 to 1280 ng/l, and in the CBAS group from 418 to 747 ng/l. The β-thromboglobulin increase was significant in each group (p < 0.01), but not between the groups (p = 0.49). The mean heparin concentrations in the Duraflo 2 group increased from 2460 at the start to 2897 IU/l at termination of the experiments, in the CBAS group from 2468 to 2518 IU/l. In the Avecor-coated oxygenator group heparin concentrations decreased from 2010 to 1968 IU/l, and in the Avecor-coated total circuit group from 2002 to 1927 IU/l. The differences in heparin concentrations were significant between the Duraflo 2 group and the other groups (p < 0.05). The mean prothrombin fragment 1+2 concentrations increased in the CBAS group from 0.4 at the start to 2.1 nmol/l at the end of the experiments, in the Avecor-coated oxygenator group from 0.4 to 0.6 nmol/l, in the Avecor-coated total circuit group from 0.3 to 0.4 nmol/l, and in the Duraflo 2 group from 1.2 to 1.3 nmol/l. The prothrombin fragment 1+2 increase was significant in all groups (p < 0.05), but there were no significant intergroup differences (p = 0.54). There were no significant differences at the termination of the experiments among the four groups regarding complement activation as measured by C3 activation products and the terminal complement complex. In the present in vitro model of a heart–lung machine, none of the three specific setups with different coatings was superior with regard to all test parameters. The CBAS group generated the highest levels of prothrombin fragment 1+2 formation, but least complement activation. The increasing plasma heparin concentrations in the Duraflo 2 group indicated more unstable heparin bonding. The Avecor-coated total circuit group were superior to the Avecor-coated oxygenator group regarding plasma concentrations of MPO, but not compared to the CBAS and Duraflo 2-coated oxygenator groups.
ACCESSION #
1801489

 

Related Articles

  • Recent advances in biocompatible surfacemodifying additives for cardiopulmonary bypass. Vijay, Venkataramana; McCusker, Kevin // Perfusion;Jan2003 Supplement, Vol. 18, p41 

    Discusses recent advances in biocompatibility of cardiopulmonary bypass (CPB) as of January, 2003. Improvement in the area of condensation of the circuit and in surface-modifying agents; Factors influencing systemic inflammatory response syndrome during CPB; Comparison of clinical outcomes of...

  • Inflammatory Reactions and Hydrocortisone in the Setting of Cardiac Surgery: An Overview. Beiras-Fernandez, Jens Heyn Andres; Luchting, Benjamin; Briegel, Josef; Weis, Florian // Cardiovascular & Hematological Agents in Medicinal Chemistry;2011, Vol. 9 Issue 2, p56 

    No abstract available.

  • Comparable biocompatibility of Phisio- and Bioline-coated cardiopulmonary bypass circuits indicated by the inflammatory response. Thiara, A. S.; Andersen, V. Y.; Videm, V.; Mollnes, T. E.; Svennevig, K.; Hoel, T. N.; Fiane, A. E. // Perfusion;Jan2010, Vol. 25 Issue 1, p9 

    Background: The biocompatibility of cardiopulmonary bypass surfaces has been improved by heparin and polymer surface modifications. The present study compared the effect of two such coatings on the inflammatory reactions after open heart surgery. Methods: Thirty patients undergoing elective...

  • Minimally invasive incision vs. sternotomy for valve repair. Sadovsky, Richard // American Family Physician;6/1/1998, Vol. 57 Issue 11, p2838 

    Presents information on the use of the median sternotomy, cardiopulmonary bypass and various degrees of systemic hypothermia in relation to classic surgery to repair or replace cardiac valves. Reference to the use of the minimally invasive or `key hole' surgery; Information on one patient...

  • Vardenafil improves myocardial and endothelial function after cardiopulmonary bypass. Szabó, Gábor; Veres, Gábor; Radovits, Tamás; Miesel-Gröschel, Christiane; Karck, Matthias // BMC Pharmacology;2007 Supplement 1, Vol. 7, pP57 

    An abstract of the paper "Vardenafil Improves Myocardial and Endothelial Function After Cardiopulmonary Bypass," by Christiane Miesel-Gröschel, Matthias Karck, and colleagues is presented.

  • Alteration of vancomycin pharmacokinetics during cardiopulmonary bypass in patients undergoing cardiac surgery. García, María Pilar Ortega; Martí-Bonmatí, Ezequiel; Serrano, Javier Guevara; Gómez, Isabel Gil // American Journal of Health-System Pharmacy;2/1/2003, Vol. 60 Issue 3, p260 

    Studies the alteration of vancomycin phramacokinetics during cardiopulmonary bypass (CPB) in patients undergoing cardiac surgery. Enrollment of 18 patients in the study; Association of the onset of (CPB) with a drop in serum vancomycin concentration.

  • A new concept of integrated cardiopulmonary bypass circuit Mueller, Xavier M.; Jegger, David; Augstburger, Monique; Horisberger, Judith; Godar, Gilles; von Segesser, Ludwig K. // European Journal of Cardio-Thoracic Surgery;May2002, Vol. 21 Issue 5, p840 

    Objective: Standard cardiopulmonary bypass (CPB) circuits with their large surface area and volume contribute to postoperative systemic inflammatory reaction and hemodilution. In order to minimize these problems a new approach has been developed resulting in a single disposable, compact...

  • Adenoviral gene transfer to the heart during cardiopulmonary bypass: effect of myocardial protection technique on transgene expression Jones, J.M.; Wilson, K.H.; Koch, W.J.; Milano, C.A. // European Journal of Cardio-Thoracic Surgery;May2002, Vol. 21 Issue 5, p847 

    Objective: Adenoviral gene transfer to the arrested heart during cardiopulmonary bypass (CPB) is a novel method of allowing prolonged vector contact with the myocardium. In this model we investigated the importance of temperature, duration of arrest and cardioplegia on transgene expression....

  • 844 Cardiac resynchronization therapy for weaning from cardiopulmonal bypass.  // European Journal of Heart Failure. Supplements;Jun2005, Vol. 4 Issue 1, p197 

    An abstract of the study "Cardiac resynchronization therapy for weaning from cardiopulmonal bypass," by S. Raab add colleagues, is presented.

Share

Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics