Biocompatibility of poly2methoxyethylacrylate coating for cardiopulmonary bypass.
The systemic inflammatory response to cardiopulmonary bypass (CPB) may contribute to the development of postoperative complications. Heparin-coated circuits and poly2methoxyethylacrylate (PMEA)-coated circuits have been developed to reduce the risk of such complications. We compared the biocompatibility of these circuits. Twelve patients scheduled to undergo elective coronary artery bypass grafting (CABG) with CPB were assigned to CPB with a PMEA-coated circuit (PMEA-coated group, n=6) or a heparin-coated circuit (heparin-coated group, n=6). The plasma concentrations of the following inflammatory markers were measured before CPB and just after, 4 hours after, and 24 hours after the termination of CPB: cytokines (interleukin [IL]-6, IL-8, IL-10), complement factor (C3a), polymorphonuclear elastase (PMNE), and coagulofibrinolytic factors (thrombin-antithrombin III complex [TAT], D-dimer). Postoperative clinical response was evaluated on the basis of respiratory index, blood loss, and the postoperative and preoperative body-weight percent ratio. There were no significant differences between the groups in the plasma concentrations of IL-6, IL-10, C3a, PMNE, TAT, or D-dimer. Plasma IL-8 concentrations were below the assay detection limits at all time points in both groups. Clinical variables did not differ significantly between the groups. In conclusion, PMEA-coated CPB circuits are as biocompatible as heparin-coated CPB circuits and prevent postoperative organ dysfunction in patients undergoing elective CABG with CPB.
Noguchi
Manabu
M
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
Eishi
Kiyoyuki
K
Tada
Seiichi
S
Yamachika
Shiro
S
Hazama
Shiro
S
Izumi
Kenta
K
Tanigawa
Kazuyoshi
K
D000179:Acrylates; D000368:Aged; D000990:Antithrombin III; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D015926:Complement C3a / Q000032:analysis; D001026:Coronary Artery Bypass; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D010447:Peptide Hydrolases / Q000097:blood; D011108:Polymers
D000179:Acrylates; D020099:Coated Materials, Biocompatible; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D016209:Interleukin-8; D011108:Polymers; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C413485:poly(2-methoxyethylacrylate); D016753:Interleukin-10; D015926:Complement C3a; D000990:Antithrombin III; D010447:Peptide Hydrolases; D019272:Leukocyte Elastase