Poly-2-methoxyethylacrylate-coated bypass circuits reduce activation of coagulation system and inflammatory response in congenital cardiac surgery.
Surface-coated cardiopulmonary bypass (CPB) has been shown to have excellent biocompatibility during cardiac surgery in adults, but there have been only a few reports demonstrating the efficacy of this coating for congenital cardiac surgery. We tested the efficacy of poly-2-methoxyethylacrylate (PMEA) coating for CPB circuits in congenital cardiac surgery. Eleven operative cases of ventricular septal defect were studied: group C (control: no coating, n = 5) and group P (PMEA coating, n = 6). The platelet count and beta-thromboglobulin (beta TG), fibrinogen (FBG), thrombin-antithrombin complex (TAT), and neutrophil elastase levels were measured during the operation. Postoperative chest tube drainage was analyzed and the surface of the artificial lung was observed with an electron microscope. Elevation of TAT and neutrophil elastase was suppressed in group P (P < 0.05). Observation of the artificial lung surface using an electron microscope clearly revealed fewer blood cells were adherent to the surface in group P. The FBG level and postoperative bleeding were relatively lower in group P, but there were no significant differences between groups. The platelet count and beta TG level were the same in both groups. We concluded that the PMEA-coated circuit reduces activation of the coagulation system and the inflammatory reaction in pediatric cardiac surgery.
Suzuki
Yasuyuki
Y
Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan. ysuzuki@cc.hirosaki-u.ac.jp
Daitoku
Kazuyuki
K
Minakawa
Masahito
M
Fukui
Kozo
K
Fukuda
Ikuo
I
D000179:Acrylates; D000990:Antithrombin III; D001772:Blood Cell Count; D001777:Blood Coagulation; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002448:Cell Adhesion; D020099:Coated Materials, Biocompatible; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006400:Hematocrit; D006801:Humans; D007223:Infant; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008855:Microscopy, Electron, Scanning; D010447:Peptide Hydrolases / Q000097:blood; D011108:Polymers; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control*; D001620:beta-Thromboglobulin / Q000032:analysis
D000179:Acrylates; D020099:Coated Materials, Biocompatible; D011108:Polymers; C046193:antithrombin III-protease complex; D001620:beta-Thromboglobulin; C413485:poly(2-methoxyethylacrylate); D000990:Antithrombin III; D005340:Fibrinogen; D010447:Peptide Hydrolases; D019272:Leukocyte Elastase