• Costas J Schulze, Lin Han, Nitin Ghorpade, Wai S Etches, Linda Stang, Arvind Koshal, and Shao Hua Wang.
• Division of Cardiothoracic Surgery, Department of Laboratory Medicine and Pathology, University of Alberta, 8440-112 Street, Edmonton, Alberta, Canada.
• J Card Surg. 2009 Jul 1; 24 (4): 363-8.

BackgroundThe interaction of blood with foreign artificial surfaces during cardiopulmonary bypass (CPB) has been recognized as a major stimulus in evoking a systemic inflammatory and metabolic response. Phosphorylcholine (PC) is a new-generation coating material designed to ameliorate biocompatibility and thereby to reduce the detrimental interactions of CPB. We studied the effects of PC-coated perfusion circuits on platelet function and the humoral and cellular response to CPB.MethodsThirty patients undergoing coronary artery bypass grafting were randomized to PC-coated (PC group, n = 15) and noncoated (control group, n = 15) circuit groups. Clinical data, total blood loss, and pre- and postoperative platelet counts were recorded and IL-6 and TNF-alpha, CD41a, CD42b, and CD62p were measured at induction of anesthesia, after the initiation of CPB and at termination of CPB.ResultsThere was a significantly improved preservation of platelet count following CPB in the PC group (p = 0.028), which was sustained over a period of 72 hours. The use of PC-coated circuits further resulted in a significant attenuation of TNF-alpha and IL-6 expression (p < 0.05 and p < 0.01); however, we were unable to detect any differences in clinical outcomes.ConclusionsDespite similar clinical outcome, the obvious reduction of cytokine expression and improved preservation of platelet count suggest superior biocompatibility of PC-coated circuits.

20 keywords...

hide…