In vivo evaluation of a phosphorylcholine coated cardiopulmonary bypass circuit

Abstract

A complete phosphorylcholine coated cardiopulmonary bypass circuit, including the Dideco D901 oxygenator, was tested for gas transfer, blood path resistance, and biocompatibility in a standardized setting. Blood compatibility was tested by measuring complement and platelet activation. Three dogs (mean body weight 28 ± 3 kg) were placed on cardiopulmonary bypass at a flow rate of 600 mL/min during 6 hours. The animals were weaned from cardiopulmonary bypass and sacrificed electively after 7 days. Oxygen and carbon dioxide transfer were 26.6 ± 2.4 mL/min and 33.0 ± 1.9 mL/min, respectively. Mean pressure drop across the oxygenator was 52.6 ± 0.2 mmHg. The respective baseline values for thromboxane B2, prostaglandin E2 and platelet factor 4 were 1817 ± 283 pg/mL, 12783 ± 2109 pg/mL, and 0.35 ± 0.08 IU/mL. Thromboxane B2 and prostaglandin E2 increased slightly to 2881 ± 868 pg/mL and 18083 ± 3144 pg/mL at 30 minutes of bypass, whereas platelet factor 4 values remained stable curing the procedure. Concentrations of complement split products C5a were only mildly increased. After use scanning electron microscopy was performed on the inner housing, heat exchanger, and outer surface of the hollow fibers. No thrombi nor organized cellular deposits were found on any of the components. Phosphorylcholine coating of CPB seems to be very promising regarding platelet activation and complement activation.