Issue |
J Extra Corpor Technol
Volume 37, Number 3, September 2005
|
|
---|---|---|
Page(s) | 290 - 295 | |
DOI | https://doi.org/10.1051/ject/200537290 | |
Published online | 15 September 2005 |
Scientific Article
Clinical Performance and Biocompatibility of Novel Hyaluronan-Based Heparin-Bonded Extracorporeal Circuits
* Department of Cardiovascular Surgery, University of Kirikkale, School of Medicine-Turkey
† New York Medical College, New York
‡ New York, New York
Presented at the 43rd International Conference of the American Society of Extra-Corporeal Technology, New Orleans, Louisiana, March 3–6, 2005
We tested documented in vitro and ex vivo advantages of novel hyaluronan based heparin bonded extracorporeal circuits in a prospective randomized study. During the period from June until September 2005, 40 patients undergoing reoperation for coronary artery bypass grafting were allocated into two equal groups (n = 20): Group 1 was treated with hyaluronan-based heparin-bonded circuits and group 2 was treated with uncoated control circuits. Complete blood count, fibrinogen, albumin, C3a, interleukin-2 levels, and thromboelastographic data were documented after induction of anesthesia (T1) and heparin administration before cardiopulmonary bypass (CPB) (T2), 15 minutes after initiation of CPB (T3), before cessation of CPB (T4), 15 minutes after reversal with protamine (T5), and the first postoperative day at 8:00 a.m. (T6). Hollow fibers were collected for consecutive biomaterial analysis by optical and scanning electron microscopy (SEM). Desorbed protein deposition on fibers was compared by spectrophotometry. Leukocyte counts were lower in T4-T6 in group 1 (p < .05). Platelet counts demonstrated significant differences at T4 and T5 in coated group (p < .05). Albumin and fibrinogen levels were better preserved in Group 1 at T4, T5 and T4, T6, consecutively (p < .05). C3a and IL-2 levels were lower at T3-T5 and T4-T5 in intervention group (p < .05). Postoperative hemorrhage was 412 ± 50 mL in group 1 and 684 ± 50 ml in group 2 (p < .05). Respiratory support time was shorter in group 1 versus control (p < .05). Platelet adhesion was significantly lower in intervention group. Amount of desorbed protein was 1.44 ± 0.01 mg/dL in group 1 and 1.94 ± 0.01 mg/dL in control (p < .05). SEM and spectrophotometry demonstrated better surface preservation in the hyaluronan coated group. Novel hyaluronan-based heparin-bonded circuits reduce platelet adhesion-aggregation and protein adsorption and provide better perioperative clinical parameters through platelet, albumin, and fibrinogen-sparing effects.
Key words: cardiopulmonary bypass / coated materials / biocompatibility / membrane oxygenators / extracorporeal circulation
Address correspondence to: Serdar Gunaydin, MD, Angora Evleri, G-8 Blok No:1 Beysukent, Ankara 06800, Turkey. E-mail: sgunaydin@isnet.net.tr
© 2005 AMSECT
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.