title: Poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit can reduce transfusion of platelet products compared to heparin-coated circuit during aortic arch surgery.
abstract: Several coating techniques for extracorporeal circulation have been developed to reduce the systemic inflammatory response during cardiopulmonary bypass (CPB). We compared the clinical effectiveness and biocompatibility of poly-2-methoxyethylacrylate (PMEA)- and heparin-coated CPB circuits in total aortic arch replacement (TAR) with the prolonged use of the bypass technique. Twenty patients who underwent elective TAR were divided randomly into two equal groups: group P (n = 10) to use PMEA-coated circuits and group H (n = 10) to use heparin-coated circuits. Clinical outcomes, hematological variables, and acute phase inflammatory response were analyzed perioperatively. Demographic, CPB, and clinical outcome data were similar for both groups. Hemoglobin and platelet count showed similar time-course curves. However, the amount of platelet products transfused intraoperatively was significantly larger in group H (group P 26.0 ± 7.0 units; group H 33.0 ± 6.7 units, p = 0.04). Total protein, and albumin levels were significantly higher in group P during and after the operation (total protein, p = 0.04; albumin, p = 0.02). The use of PMEA-coated circuit is associated with retainment of perioperative plasma proteins levels and may help to reduce transfusion of platelet products in TAR in comparison with the heparin-coated circuit.
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan. k.hosoyama@med.tohoku.ac.jp.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hosoyama
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Ito
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kawamoto
authors.affiliation: Research Division of Sciences for Aortic Disease, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Adachi
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawatsu
authors.affiliation: Research Division of Sciences for Aortic Disease, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Konosuke
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Research Division of Sciences for Aortic Disease, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Marina
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Division of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Department of Clinical Engineering, Division of Operation, Tohoku University Hospital, Sendai, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
mesh_terms: D000179:Acrylates / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000601:surgery*; D001792:Blood Platelets; D002315:Cardiopulmonary Bypass / Q000379:methods*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D005112:Extracorporeal Circulation; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000627:therapeutic use*
chemical_list: D000179:Acrylates; D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D011108:Polymers; C413485:poly(2-methoxyethylacrylate); D006493:Heparin
keywords: Aortic arch surgery; Cardiopulmonary bypass; Inflammatory response; PMEA coating