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The impact of different biocompatible coated cardiopulmonary bypass circuits on inflammatory response and oxidative
1Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0W8 Canada.
Insights
Heparin-coated and Phosphorylcholine-coated circuits reduce inflammatory response and oxidative stress during cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) surgery compared to other biocompatible coatings.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Immunology
- Biochemistry
Background:
- Cardiopulmonary bypass (CPB) is integral to coronary artery bypass grafting (CABG) surgery.
- CPB can induce significant inflammatory responses and oxidative stress.
- Biocompatible coatings on CPB circuits aim to mitigate these adverse effects.
Purpose of the Study:
- To compare the efficacy of different biocompatible coated circuits in modulating inflammatory and oxidative stress markers during CPB.
- To evaluate specific coatings including Trillium, Bioline, Phosphorylcholine, and Polymethoxyethyl acrylate (PMEA) against an uncoated control.
Main Methods:
- Seventy-eight patients undergoing elective CABG with CPB were randomized into five groups.
- Groups received circuits with Trillium, Bioline, Phosphorylcholine, PMEA coatings, or an uncoated control.
- Serum inflammatory markers (TNF-alpha, IL-6, IL-10) and oxidative stress markers (NOx, Myeloperoxidase) were measured pre-CPB, and 6 and 72 hours post-CPB.
Main Results:
- Bioline and Phosphorylcholine coatings showed significantly lower increases in TNF-alpha at 72 hours compared to Trillium.
- IL-6 increased significantly post-CPB across all groups.
- Phosphorylcholine and Bioline groups demonstrated significant reductions in NOx levels at 6 hours post-CPB compared to baseline and other groups.
- Myeloperoxidase levels were elevated in all groups post-CPB.
Conclusions:
- Heparin-coated and Phosphorylcholine-coated circuits appear to induce less inflammatory response and oxidative stress during CPB.
- These findings suggest that specific biocompatible coatings can attenuate the systemic inflammatory and oxidative burden associated with CPB in CABG patients.
Abstract:
This study was to compare the impact of different biocompatible coated circuits on inflammatory response and oxidative stress induced during cardiopulmonary bypass (CPB). Seventy-eight patients undergoing elective coronary artery bypass grafting (CABG) with CPB were randomly assigned to five groups with different biocompatible coated circuits: Trillium, Bioline, Phosphorylcholine, Polymethoxyethyl acrylate (PMEA), and the uncoated control group. Blood was drawn at three different time points: before CPB, 6 and 72 hours post CPB. Unlike the Trillium group, serum levels of TNF-alpha in the Bioline and Phosphorylcholine groups significantly increased only at 72 hours post CPB (p < 0.05). Serum levels of IL-6 significantly increased at 6 and 72 hours post CPB in all groups (p < 0.01). The Trillium group showed a significant increase of IL-10 compared to the control group at 72 hours post CPB (p < 0.05). Serum levels of NOx in the Phosphorylcholine group significantly decreased at 6 hours post CPB compared to baseline (p < 0.05). Both the Bioline and Phosphorylcholine groups showed statistical decreases in serum NOx levels compared with other groups at 6 hours post CPB (p < 0.05). A significant difference in NOx levels between the Bioline and the control group was also observed at 72 hours post CPB. Myeloperoxidase levels were significantly elevated at 6 and 72 hours post CPB in all groups (p < 0.05). Inflammatory response and oxidative stress are elevated during CABG with CPB. Heparin-coated and the Phosphorylcholine-coated circuits induce less inflammatory responses and oxidative stress compared to other circuits.
