Experimental Research With Synthetic Copolymer‐Coated Cardiopulmonary Bypass Circuits: Inflammatory and Thrombogenicity Analysis

Abstract

This study aimed to assess complement system activation and index of thrombogenicity and platelet aggregation between synthetic copolymer-coated cardiopulmonary bypass (CPB) circuit and conventional CPB circuit. Twenty-six pigs were equally divided into two groups--the conventional group and the coated group. They were placed on CPB for 90 min, and blood samples were collected at three different time points (T0, right before CPB establishment; T1, 45 min after starting CPB; and T2, 90 min after starting CPB) to measure total count of inflammatory cells (leukocytes, neutrophils, lymphocytes, and platelets) and serum levels of fraction C3 of complement system. Upon completion of the 90-min CPB, fragments of different compartments of the CPB circuit were taken for assessing index of thrombogenicity and platelet aggregation. There were no differences between both groups regarding total count of leukocytes, neutrophils, and lymphocytes; however, there was a lower count of platelets at T2 in the coated group (P = 0.020). The serum level of fraction C3 was lower in the coated group at T1 (P = 0.020) and T2 (P = 0.017). Higher index of thrombogenicity and platelet aggregation were detected in the conventional group (77% of the animals within the conventional group) than in the coated group (46% of the animals within the coated group). In conclusion, in heart surgery requiring CPB, the use of synthetic copolymer-coated CPB circuit may be useful to reduce complement system activation, as well as attenuating index of thrombogenicity and platelet aggregation.

Managing the inflammatory response after cardiopulmonary bypass: review of the studies in animal models

“…Other variables were assessed by least amount of studies, but also showed relevant results to clinical practice. Gabriel et al [ 32 ] sought to investigate the use of a coated synthetic copolymer (methacrylate), showing lower circuit platelet aggregation, but no differences in the number of leukocytes, compared with the control group. The use of mini-sternotomy was studied by Hayashi et al [ 33 ] showing no difference with the traditional technique at the end of procedure.…”

Plasma proteomic changes during hypothermic and normothermic cardiopulmonary bypass in aortic surgeries

“…This activation can improperly stimulate biological processes that may contribute to the development of postoperative complications resulting from the dysfunction of blood cells, coagulation, fibrinolysis, and the kinin-kallikrein and immune systems (14–16). Various modifications to the inner surface of the CPB circuit, including heparin- and polymer-coating, reduce adverse effects on complement activation, blood coagulation, proinflammatory cytokines and improve clinical outcomes (17–20). The C5 complement inhibitor pexelizumab and a complement factor 1 esterase inhibitor have been tested clinically (21) and in an animal study (22) for their abilities to reduce complement activation during CPB.…”

Artificial Organs 2012: A Year in Review

“…Edmo Atique Gabriel et al. of the Albert Einstein Jewish Hospital, São Paulo, Brazil assessed the complement system activation and index of thrombogenicity and platelet aggregation between a synthetic copolymer‐coated cardiopulmonary bypass (CPB) circuit and the conventional CPB circuit. Twenty‐six pigs were equally divided into two groups—the conventional group and the coated group.…”