Phosphorylcholine coating of bypass systems used for young infants does not attenuate the inflammatory response

被引:11
作者
Draaisma, AM
Hazekamp, MG
Anes, N
Schoof, PH
Hack, CE
Sturk, A
Dion, RAE
机构
[1] Leiden Univ, Med Ctr, Dept Extra Corporeal Circulat, NL-2300 RC Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Cardiothorac Surg, NL-2300 RC Leiden, Netherlands
[3] CLB, Sanquin Res, Dept Immunopathol, Amsterdam, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands
关键词
D O I
10.1016/j.athoracsur.2005.11.058
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Contact of blood with the artificial surfaces of the cardiopulmonary bypass ( CPB) system is considered to be a main cause of complement activation. Improving the biocompatibility of the system by reduction of contact activation of blood elements and thereby producing less inflammatory response is evidently desired, especially for neonates and infants who are more susceptible to the deleterious effects of CPB. A phosphorylcholine coating, Phisio, is designed to mimic the natural interfaces of blood. The aim of this study is to compare the influence of a phosphorylcholine-coated CPB system versus an uncoated CPB system on complement activation and clinical outcomes. Methods. In this prospective, randomized, blind, one-center study, 28 neonates and infants with a bodyweight between 3 and 6 kg who were undergoing cardiopulmonary bypass were divided in two groups, the phosphorylcholine group and the control group. Thirteen patients were assigned to the phosphorylcholine group and 15 patients to the control group. Patients with Down syndrome, prematurity, cyanosis, or reoperation were excluded. Complement factor C3b/ c, human neutrophil elastase ( HNE), interleukin- 6, and C- reactive protein were measured before, during, and after CPB. Duration of intensive care stay, ventilation time, highest body temperature, and inotropic medication were the clinical variables. Results. No significant differences were found between the groups for complement factor C3b/ c, HNE, interleukin- 6, or C- reactive protein during and after CPB. No clinical differences were observed between the groups. Conclusions. Phosphorylcholine coating does not attenuate the complement activation during CPB in neonates and infants.
引用
收藏
页码:1455 / 1459
页数:5
相关论文
共 22 条
[1]   Inflammatory response after coronary revascularization with or without cardiopulmonary bypass [J].
Ascione, R ;
Lloyd, CT ;
Underwood, MJ ;
Lotto, AA ;
Pitsis, AA ;
Angelini, GD .
ANNALS OF THORACIC SURGERY, 2000, 69 (04) :1198-1204
[2]   Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress [J].
Biglioli, P ;
Cannata, A ;
Alamanni, F ;
Naliato, M ;
Porqueddu, M ;
Zanobini, M ;
Tremoli, E ;
Parolari, A .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2003, 24 (02) :260-269
[3]   Phosphorylcholine or heparin coating for pediatric extracorporeal circulation causes similar biologic effects in neonates and infants [J].
Böning, A ;
Scheewe, J ;
Ivers, T ;
Friedrich, C ;
Stieh, J ;
Freitag, S ;
Cremer, JT .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2004, 127 (05) :1458-1465
[4]   Chronic hypoxia: A model for cyanotic congenital heart defects [J].
Corno, AF ;
Milano, G ;
Samaja, M ;
Tozzi, P ;
von Segesser, LK .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2002, 124 (01) :105-112
[5]   Phosphorylcholine coating of extracorporeal circuits provides natural protection against blood activation by the material surface [J].
De Somer, F ;
François, K ;
van Oeveren, W ;
Poelaert, J ;
De Wolf, D ;
Ebels, T ;
Van Nooten, G .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2000, 18 (05) :602-606
[6]   NF-κB and rel proteins:: Evolutionarily conserved mediators of immune responses [J].
Ghosh, S ;
May, MJ ;
Kopp, EB .
ANNUAL REVIEW OF IMMUNOLOGY, 1998, 16 :225-260
[7]  
HAENEY M, 1994, J ANTIMICROB CHEMOTH, V34, P1
[8]   Interleukin-6 levels in serum and lung lavage fluid of children undergoing open heart surgery correlate with postoperative morbidity [J].
Hauser, GJ ;
Ben-Ari, J ;
Colvin, MP ;
Dalton, HJ ;
Hertzog, JH ;
Bearb, M ;
Hopkins, RA ;
Walker, SM .
INTENSIVE CARE MEDICINE, 1998, 24 (05) :481-486
[9]   IL-6 and IL-8 levels after cardiopulmonary bypass are not affected by surface coating [J].
Horton, SB ;
Butt, WW ;
Mullaly, RJ ;
Thuys, CA ;
O'Connor, EB ;
Byron, K ;
Cochrane, AD ;
Brizard, CP ;
Karl, TR .
ANNALS OF THORACIC SURGERY, 1999, 68 (05) :1751-1755
[10]  
KIRKLIN JK, 1983, J THORAC CARDIOV SUR, V86, P845