Tethered Liquid Perfluorocarbon Coating for 72 Hour Heparin-Free Extracorporeal Life Support.

Area of Science:

• Biomaterials Science
• Cardiovascular Engineering
• Medical Device Development

Background:

• Extracorporeal life support (ECLS) faces challenges with coagulopathic complications due to foreign surface interactions and anticoagulation.
• Biocompatible coatings aim to reduce these complications by preventing protein adsorption and thrombus formation.
• Tethered liquid perfluorocarbon (TLP) is a nonadhesive coating with potential for ECLS applications.

Purpose of the Study:

• To evaluate the efficacy of TLP-coated ECLS circuits in preventing coagulopathy and device thrombosis without systemic anticoagulation.
• To compare the performance of TLP-coated circuits against standard heparin-coated circuits in a swine model.
• To assess gas exchange, bleeding, thrombotic complications, and systemic effects during 72 hours of ECLS.

Main Methods:

• TLP was applied to complete ECLS circuits (membranes, tubing, pumps, catheters).
• Healthy swine (n=5/group) underwent 72 hours of ECLS using either TLP-coated circuits without anticoagulation or standard heparin-coated circuits with heparin infusion.
• Coagulopathic complications, device performance (occlusion, gas exchange), and systemic effects were monitored.

Main Results:

• No significant difference in bleeding or thrombotic complication rates between TLP and control groups.
• Circuit occlusion occurred in both TLP (2/5) and control (1/5) groups.
• TLP circuits required higher sweep gas rates for normocapnia, indicating impaired gas exchange (p=0.047).
• Thrombus deposition and protein adhesion were comparable; TLP did not preserve blood cell counts.

Conclusions:

• Neither TLP coatings nor standard heparin effectively prevent coagulation disturbances during ECLS.
• TLP coatings may impair gas exchange performance in ECLS circuits.
• Further investigation of novel biomaterials for ECLS is necessary, utilizing robust preclinical models.