title: Biocompatibility and pathways of initial complement pathway activation with Phisio- and PMEA-coated cardiopulmonary bypass circuits during open-heart surgery.
abstract: A randomized open-heart surgery study comprising 30 patients was undertaken to compare the biocompatibility of Phisio-(phosphorylcholine) and PMEA-(poly-2-methoxyethyl acrylate) coated cardiopulmonary bypass (CPB) circuits and to assess the initial complement pathway activation during open-heart surgery. Blood samples were obtained at five time points, from the start of surgery to 24 hours postoperatively. The following analyses were performed: haemoglobin, lactate dehydrogenase, leukocyte and platelet counts, myeloperoxidase and neutrophil-activating peptide-2, thrombin-anti-thrombin complexes, syndecan-1 and the complement activation products C1rs-C1-inhibitor complexes, C4bc, C3bc, C3bBbP and the terminal complement complex (TCC). No significant inter-group difference was found in any parameters, except for the concentration of TCC which was moderately lower in the PMEA group at termination of CPB. Complement activation during open-heart surgery was mainly mediated through the alternative pathway. In conclusion, PMEA- and Phisio-coated circuits displayed similar biocompatibility with respect to inflammatory and haemostatic responses during and after open-heart surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway. amrit.thiara@rikshospitalet.no
authors.forename: A S
authors.initials: AS
authors.lastname: Thiara
authors.forename: T E
authors.initials: TE
authors.lastname: Mollnes
authors.forename: V
authors.initials: V
authors.lastname: Videm
authors.forename: V Y
authors.initials: VY
authors.lastname: Andersen
authors.forename: K
authors.initials: K
authors.lastname: Svennevig
authors.forename: S O
authors.initials: SO
authors.lastname: Kolset
authors.forename: A E
authors.initials: AE
authors.lastname: Fiane
mesh_terms: D000179:Acrylates / Q000276:immunology*; D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000378:metabolism*; D003167:Complement Activation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010767:Phosphorylcholine / Q000276:immunology*; D011108:Polymers
chemical_list: D000179:Acrylates; D020099:Coated Materials, Biocompatible; D011108:Polymers; C413485:poly(2-methoxyethylacrylate); D010767:Phosphorylcholine