Evaluation of Carmeda® Bioactive Surface (CBAS®), Duraflo II and a novel nonspecific protease-modified surface using a new in vitro model simulating cardiopulmonary bypass

Yii, Michael; Gourlay, Terence; Fleming, John; Matata, Bashir M.; Taylor, KM

doi:10.1177/026765919601100308

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…Improvements in biocompatibility have been demonstrated by comparing the performance of a coated system with a non-coated, otherwise identical, system with respect to thrombogenicity, the levels of inflammatory mediators generated, and other biochemical properties. [11][12][13][14] We have previously shown that Duraflo heparin-coated circuits significantly reduced fibrinogen adsorption, platelet adhesion, and platelet activation. 15 Additional comparative results from the same experimental design are shown in Figures 2-4.…”

Section: Effects Of Heparin Coating On Materialdependent Blood Activationmentioning

confidence: 98%

Heparin-coated cardiopulmonary bypass circuits: current status

Hsu

2001

Perfusion

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Heparin-coated circuits have been subjected to vigorous testing, both experimentally and clinically, for the past decade. When the functions of heparin are preserved on the surface, the heparinized surface plays multiple roles in attenuating the systemic inflammatory response. These include the ability to attenuate contact activation, coagulation activation, complement activation and, directly or indirectly, platelet and leukocyte activation. The heparinized surface also renders the cardiopulmonary bypass (CPB) circuits hydrophilic and protein resistant and augments lipoprotein binding. The multifunctional nature of the heparinized surface contributes to the overall biocompatibility of the surface. Clinically, heparin-coated circuits become most effective in reducing systemic inflammatory response and in improving morbidity, mortality, and other patient outcome related parameters when material-independent blood activation is controlled or minimized through a global biocompatibility strategy. Techniques involved in the global biocompatibility strategy are readily available and are being effectively and safely practiced at several centers. With the global biocompatibility strategy, outstanding and reproducible results have been routinely achieved with conventional CPB techniques. Alternative revascularization procedures should equal or surpass conventional CPB, using best clinically proven strategies with respect to patient outcome and long-term graft patency.

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Section: Effects Of Heparin Coating On Materialdependent Blood Activationmentioning

confidence: 98%

Heparin-coated cardiopulmonary bypass circuits: current status

Hsu

2001

Perfusion

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“…This small volume, in vitro model enabled isolated biomaterials to be studied using fresh human blood. 27 However, the importance of the interaction between the active complexes and activated blood cells, resulting from blood contact with the materials and living tissue, is beyond the scope of this particular model. It is, therefore, necessary to move to either animal or clinical models to fully describe the inflammatory effects of blood-biomaterial interaction.…”

Section: Development Of Rodent Recirculation Modelmentioning

confidence: 99%

Biomaterial development for cardiopulmonary bypass

Gourlay

2001

Perfusion

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Cardiopulmonary bypass (CPB) is dependent on materials foreign to the patient for its successful application. When blood comes into contact with these so-called biomaterials, an inappropriate inflammatory response, which can be life-threatening in some patients, may develop. The reason for this inappropriate activation of host defence mechanisms is not entirely clear, however a number of strategies have evolved over the years to minimize this unwanted sequelae of CPB. These strategies include surface coating of the materials of the circuit, using new materials thought to improve biocompatibility, and using a number of pharmacological interventions designed to suppress the inflammatory response. Recently, there has been some evidence which indicates that the plasticizer employed in the polyvinyl chloride (PVC) tubing of the CPB circuit may play a part in the development of the inflammatory response. The work described in this paper tends to support this thesis. These studies showed that by washing the plasticizer from the surface of the PVC tubing, the biocompatibility, as reflected in the upregulation of CD11b on the surface of neutrophils, was enhanced. Furthermore, the use of non-plasticized substitutes for PVC had a similar effect. The benefit from removing the plasticizer was similar to that gained from surface coating with heparin, one of the conventional approaches to reducing the inflammatory response to CPB.

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“…Thus, factor XII activation is not always indispensable for thrombin generation during CPB. Recent improvements in biocompatibility of the extracorporeal circuit, such as heparin coatings, have resulted in considerably less blood activation [42,[221][222][223][224]. Despite these improvements, however, we and also other investigators reported no reduction in thrombin generation in patients undergoing CPB with the use of a heparin-coated extracorporeal circuit [11,56,225,226], whereas others have found evidence of some possible benefit of these surfaces on the coagulation cascade [146].…”

Section: Introductionmentioning

confidence: 70%

Hemocompatibility during extracorporeal circulation for cardiopulmonary bypass

Weerwind¹

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Evaluation of Carmeda® Bioactive Surface (CBAS®), Duraflo II and a novel nonspecific protease-modified surface using a new in vitro model simulating cardiopulmonary bypass

Cited by 10 publications

References 24 publications

Heparin-coated cardiopulmonary bypass circuits: current status

Heparin-coated cardiopulmonary bypass circuits: current status

Biomaterial development for cardiopulmonary bypass

Hemocompatibility during extracorporeal circulation for cardiopulmonary bypass

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