Phosphorylcholine coating of bypass systems used for young infants does not attenuate the inflammatory response.
BACKGROUND
Contact of blood with the artificial surfaces of the cardiopulmonary bypass (CPB) system is considered to be a main cause of complement activation. Improving the biocompatibility of the system by reduction of contact activation of blood elements and thereby producing less inflammatory response is evidently desired, especially for neonates and infants who are more susceptible to the deleterious effects of CPB. A phosphorylcholine coating, Phisio, is designed to mimic the natural interfaces of blood. The aim of this study is to compare the influence of a phosphorylcholine-coated CPB system versus an uncoated CPB system on complement activation and clinical outcomes.


METHODS
In this prospective, randomized, blind, one-center study, 28 neonates and infants with a bodyweight between 3 and 6 kg who were undergoing cardiopulmonary bypass were divided in two groups, the phosphorylcholine group and the control group. Thirteen patients were assigned to the phosphorylcholine group and 15 patients to the control group. Patients with Down syndrome, prematurity, cyanosis, or reoperation were excluded. Complement factor C3b/c, human neutrophil elastase (HNE), interleukin-6, and C-reactive protein were measured before, during, and after CPB. Duration of intensive care stay, ventilation time, highest body temperature, and inotropic medication were the clinical variables.


RESULTS
No significant differences were found between the groups for complement factor C3b/c, HNE, interleukin-6, or C-reactive protein during and after CPB. No clinical differences were observed between the groups.


CONCLUSIONS
Phosphorylcholine coating does not attenuate the complement activation during CPB in neonates and infants.
Department of Extra Corporeal Circulation, Leiden University Medical Center, Leiden, The Netherlands. a.m.draaisma@lumc.nl
Anjo M
AM
Draaisma
Mark G
MG
Hazekamp
Nanning
N
Anes
Paul H
PH
Schoof
C Erik
CE
Hack
Augueste
A
Sturk
Robert A E
RA
Dion
D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D003167:Complement Activation; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D010767:Phosphorylcholine; D011446:Prospective Studies; D017211:Treatment Failure
D010767:Phosphorylcholine