A new poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit possesses superior platelet preservation and inflammatory suppression efficacy.
BACKGROUND
Poly-2-methoxyethylacrylate (PMEA) is a new coating material, and several studies have revealed that PMEA-coated cardiopulmonary bypass (CPB) circuits have good biocompatibility. This study sought to compare this biocompatibility with those of heparin-coated and noncoated circuits.


METHODS
Forty-five patients undergoing coronary artery bypass grafting were randomly assigned to PMEA-coated (group P, n = 15), heparin-coated (group H, n = 15), or noncoated (group N, n = 15) circuit groups. Clinical data and the following markers were analyzed: (1) platelet preservation by number of platelets; (2) complement (C) activation by C3a and C4a levels; (3) inflammatory response by interleukin-6 (IL-6) and interleukin-8 (IL-8) levels.


RESULTS
Platelet numbers were significantly preserved in group P compared with groups N and H. Postoperative blood loss did not differ among the groups. During CPB, C3a values were significantly lower in group H (536 +/- 145 ng/mL) than in group P (1,458 +/- 433 ng/mL, p < 0.01) and group N (1,815 +/- 845 ng/mL, p < 0.01). The C4a values did not differ 60 minutes after CPB initiation among the groups. The IL-6 and IL-8 levels were significantly lower in group P and group H than in group N.


CONCLUSIONS
The PMEA coating was superior to heparin coating and noncoating in preserving platelets, and was equivalent to heparin coating in terms of the perioperative clinical course and inhibition of inflammatory cytokines, but slightly inferior in reducing complement activation.
Ikuta
Takeshi
T
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. nama@msic.med.osaka-cu.ac.jp
Fujii
Hiromichi
H
Shibata
Toshihiko
T
Hattori
Koji
K
Hirai
Hidekazu
H
Kumano
Hiroshi
H
Suehiro
Shigefumi
S
D000179:Acrylates / Q000494:pharmacology; D000368:Aged; D000925:Anticoagulants; D002315:Cardiopulmonary Bypass; D020099:Coated Materials, Biocompatible; D015926:Complement C3a / Q000032:analysis; D015934:Complement C4a / Q000032:analysis; D005260:Female; D006493:Heparin; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D010976:Platelet Count; D011108:Polymers / Q000494:pharmacology
D000179:Acrylates; D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D011108:Polymers; C413485:poly(2-methoxyethylacrylate); D015926:Complement C3a; D015934:Complement C4a; D006493:Heparin