Hirudin protects from leukocyte/endothelial cell interaction induced by extracorporeal circulation.
BACKGROUND
The clinical complications of Extracorporeal Circulation (ECC) have been linked to disturbances in the microcirculation. In order to prevent these deleterious effects, a biodegradeable agent to coat the extracorporeal circuit was tested.


METHODS
Intravital fluorescence microscopy was used on the hamster skinfold chamber model in permanently instrumented, awake animals. ECC was introduced via a micro-roller-pump and a silicon tube shunted between the carotid artery and the jugular vein. The ECC-tube system was coated with PEG-Hirudin-Iloprost, two additional groups received either Iloprost i.v. (0.8 mg/kg/h) or Hirudin i.v. (1 mg/kg b.w.).


RESULTS
ECC for 20 minutes resulted in an increase in rolling and adherent leukocytes in postcapillary venules (Roller 9 to 36 [%]; Sticker 24 to 330 [n/mm2]). Use of the coated tube system reduced L/E cell interaction (Roller 9 to 24* [%], Sticker 28 to 194* [n/mm2]; *p<0.05), whereas Hirudin i.v. nearly abolished it.


CONCLUSIONS
The protective effects of the coating and of Hirudin i.v are probably a result of an attenuated activation of the coagulation-fibrinolytic system.
Kamler
M
M
Department of Thoracic and Cardiovascular Surgery, University of Essen, Germany. markus.kamler@uni-essen.de
Chatterjee
T
T
Stemberger
A
A
Gebhard
M M
MM
Hagl
S
S
Jakob
H
H
D000818:Animals; D000991:Antithrombins / Q000494:pharmacology*; D001160:Arterioles / Q000187:drug effects; D002448:Cell Adhesion / Q000187:drug effects; D002450:Cell Communication / Q000187:drug effects; D002940:Circadian Rhythm / Q000187:drug effects; D006224:Cricetinae; D004195:Disease Models, Animal; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000166:cytology* / Q000187:drug effects* / Q000502:physiology; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D006439:Hemodynamics / Q000187:drug effects; D006629:Hirudins / Q000494:pharmacology*; D007962:Leukocytes / Q000187:drug effects* / Q000502:physiology; D008647:Mesocricetus; D008833:Microcirculation / Q000187:drug effects; D009131:Muscle, Smooth, Vascular / Q000098:blood supply; D013997:Time Factors; D014699:Venules / Q000187:drug effects
D000991:Antithrombins; D006629:Hirudins