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Phosphorylcholine‐Coated Circuits Improve Preservation of Platelet Count and Reduce Expression of Proinflammatory Cytokines in CABG: A Prospective Randomized Trial
Author(s) -
Schulze Costas J.,
Han Lin,
Ghorpade Nitin,
Etches Wai S.,
Stang Linda,
Koshal Arvind,
Wang Shao Hua
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2009.00895.x
Subject(s) - medicine , cardiopulmonary bypass , phosphorylcholine , platelet , proinflammatory cytokine , anesthesia , artery , perfusion , whole blood , immunology , inflammation , biochemistry , chemistry
Background: The interaction of blood with foreign artificial surfaces during cardiopulmonary bypass (CPB) has been recognized as a major stimulus in evoking a systemic inflammatory and metabolic response. Phosphorylcholine (PC) is a new‐generation coating material designed to ameliorate biocompatibility and thereby to reduce the detrimental interactions of CPB. We studied the effects of PC‐coated perfusion circuits on platelet function and the humoral and cellular response to CPB. Methods: Thirty patients undergoing coronary artery bypass grafting were randomized to PC‐coated (PC group, n = 15) and noncoated (control group, n = 15) circuit groups. Clinical data, total blood loss, and pre‐ and postoperative platelet counts were recorded and IL‐6 and TNF‐α, CD41a, CD42b, and CD62p were measured at induction of anesthesia, after the initiation of CPB and at termination of CPB. Results: There was a significantly improved preservation of platelet count following CPB in the PC group (p = 0.028), which was sustained over a period of 72 hours. The use of PC‐coated circuits further resulted in a significant attenuation of TNF‐α and IL‐6 expression (p < 0.05 and p < 0.01); however, we were unable to detect any differences in clinical outcomes. Conclusions: Despite similar clinical outcome, the obvious reduction of cytokine expression and improved preservation of platelet count suggest superior biocompatibility of PC‐coated circuits.