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

Anjo M Draaisma1, Mark G Hazekamp, Nanning Anes

  • 1Department of Extra Corporeal Circulation, Leiden University Medical Center, Leiden, The Netherlands. a.m.draaisma@lumc.nl

The Annals of Thoracic Surgery
|March 28, 2006
PubMed

Insights

Phosphorylcholine coating did not reduce complement activation or improve clinical outcomes in neonates and infants undergoing cardiopulmonary bypass (CPB). This study found no significant differences between coated and uncoated CPB systems.

Area of Science:

  • Biomaterials Science
  • Pediatric Cardiology
  • Immunology

Background:

  • Cardiopulmonary bypass (CPB) systems activate complement, causing inflammation, particularly harmful to neonates and infants.
  • A phosphorylcholine coating (Phisio) aims to improve CPB biocompatibility by mimicking natural blood interfaces.
  • Reducing CPB-induced inflammation is crucial for vulnerable pediatric populations.

Purpose of the Study:

  • To compare the effects of a phosphorylcholine-coated CPB system versus an uncoated system on complement activation.
  • To evaluate the influence of the coating on clinical outcomes in neonates and infants undergoing CPB.

Main Methods:

  • A prospective, randomized, blind, one-center study included 28 neonates and infants (3-6 kg bodyweight).
  • Patients were divided into a phosphorylcholine-coated group (n=13) and a control group (n=15).
  • Complement factors (C3b/c, HNE, IL-6, CRP) and clinical variables (ICU stay, ventilation time, temperature, inotropes) were measured.

Main Results:

  • No significant differences in complement activation markers (C3b/c, HNE, IL-6, CRP) were observed between the groups.
  • No significant clinical differences were found between the phosphorylcholine-coated and control CPB groups.
  • The phosphorylcholine coating did not attenuate complement activation during CPB.

Conclusions:

  • Phosphorylcholine coating failed to reduce complement activation in neonates and infants during CPB.
  • The tested coating did not demonstrate clinical benefits in this pediatric CPB population.
  • Further research may be needed to explore alternative biocompatible CPB strategies.
Abstract

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