Comparable biocompatibility of Phisio- and Bioline-coated cardiopulmonary bypass circuits indicated by the inflammatory response.
BACKGROUND
The biocompatibility of cardiopulmonary bypass surfaces has been improved by heparin and polymer surface modifications. The present study compared the effect of two such coatings on the inflammatory reactions after open heart surgery.


METHODS
Thirty patients undergoing elective heart surgery were randomly assigned to receive one of two types of coated circuits: Bioline (n=15) or phosphorylcholine (Phisio, n=15). The platelet and leukocyte counts, neutrophil activation (myeloperoxidase), complement activation (C3a and TCC), concentrations of lactate dehydrogenase, 27 cytokines (including interleukins, chemokines and growth factors), thrombin-antithrombin complexes, and the endothelial cell marker syndecan-1 were analyzed at five predetermined time points until 24 hrs post operatively.


RESULTS
Most measurements were comparable in both groups. However, myeloperoxidase was significantly higher in the Bioline group (p < 0.001). Postoperative lactate dehydrogenase concentrations were significantly higher in the Phisio group (p<0.01) and the maximal concentration of thrombin-antithrombin complexes 2 hours postoperatively tended to be higher in the Phisio group (p=0.08), consistent with a longer aortic cross-clamp and cardiopulmonary bypass time.


CONCLUSIONS
The two circuits exhibited a comparable degree of in vivo biocompatibility.
Thiara
A S
AS
Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway. amrit.thiara@rikshospitalet.no
Andersen
V Y
VY
Videm
V
V
Mollnes
T E
TE
Svennevig
K
K
Hoel
T N
TN
Fiane
A E
AE
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000276:immunology; D000990:Antithrombin III; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods*; D020099:Coated Materials, Biocompatible / Q000009:adverse effects*; D015926:Complement C3a / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006493:Heparin / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D010455:Peptides / Q000009:adverse effects / Q000276:immunology; D009195:Peroxidase / Q000097:blood; D010767:Phosphorylcholine / Q000009:adverse effects* / Q000276:immunology; D010976:Platelet Count; D053668:Syndecan-1 / Q000097:blood; D013927:Thrombosis / Q000188:drug therapy / Q000276:immunology*
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D016207:Cytokines; D006454:Hemoglobins; D010455:Peptides; C508241:SDC1 protein, human; D053668:Syndecan-1; C046193:antithrombin III-protease complex; D010767:Phosphorylcholine; D015926:Complement C3a; D000990:Antithrombin III; D006493:Heparin; D007770:L-Lactate Dehydrogenase; D009195:Peroxidase; D010447:Peptide Hydrolases