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Evaluation of Duraflo II heparin immobilized cardiopulmonary bypass circuits
1Baxter Healthcare Corporation, Bentley Laboratories Division, Irvine, California 92714.
Insights
Duraflo II heparin-treated cardiopulmonary bypass circuits improve blood compatibility. These synthetic circuits better preserve platelet function and reduce thrombus formation during bypass, offering significant benefits.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Hematology
Background:
- Cardiopulmonary bypass (CPB) involves significant blood-synthetic surface interaction.
- This interaction can lead to blood cell activation and plasma protein changes.
- Optimizing blood compatibility in CPB circuits is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of Duraflo II heparin-treated CPB circuits.
- To assess the impact of these circuits on blood cell activation and protein alterations.
- To determine if improved blood compatibility offers benefits during CPB.
Main Methods:
- Calves were subjected to 4-hour CPB using Duraflo II circuits.
- Activated clotting times were maintained >480 seconds with systemic heparin.
- Blood samples were analyzed for platelet count, function, and fibrinopeptide A levels.
- Thrombus deposition on circuits was assessed.
Main Results:
- The Duraflo II group showed better preserved platelet number and function compared to controls.
- Lower fibrinopeptide A levels were observed in the Duraflo II group.
- No thrombus deposition was found in the Duraflo II treated group during bypass.
Conclusions:
- Duraflo II heparin-treated circuits enhance blood compatibility during CPB.
- These circuits mitigate adverse effects like platelet activation and thrombus formation.
- Improved extracorporeal circuit design provides measurable benefits even with high systemic heparin doses.
Abstract:
Cardiopulmonary bypass (CPB) involves extensive contact between blood and synthetic surfaces and may result in blood cell activation and plasma protein alterations. This study determines the effect of Duraflo II heparin treated CPB circuits (Bentley Laboratories, Irvine, CA) on calves under simulated clinical conditions. Calves were placed on CPB for 4 hr, and activated clotting times were maintained above 480 sec with systemic heparin. Better preserved platelet number and function, lower fibrinopeptide A levels, and lack of thrombus deposition were observed in the Duraflo II treated group, relative to the untreated control group, during the entire bypass period. The results suggest that despite high doses of circulating heparin in calves during CPB, the use of extracorporeal circuits with improved blood compatibility still provides measurable benefit.