Biocompatibility of Poly2methoxyethylacrylate Coating for Cardiopulmonary Bypass
Manabu Noguchi, MD, Kiyoyuki Eishi, PhD, Seiichi Tada, MD, Shiro Yamachika, MD, Shiro Hazama, MD, Kenta Izumi, MD, and Kazuyoshi Tanigawa, MD
The systemic inflammatory response to cardiopulmonary bypass (CPB) may contribute to the development of postoperative complications. Heparin-coated circuits and poly2methoxyethylacrylate (PMEA)-coated circuits have been developed to reduce the risk of such complications. We compared the biocompatibility of these circuits. Twelve patients scheduled to undergo elective coronary artery bypass grafting (CABG) with CPB were assigned to CPB with a PMEA-coated circuit (PMEA-coated group, n=6) or a heparin-coated circuit (heparin-coated group, n=6). The plasma concentrations of the following inflammatory markers were measured before CPB and just after, 4 hours after, and 24 hours after the termination of CPB: cytokines (interleukin [IL]-6, IL-8, IL-10), complement factor (C3a), polymorphonuclear elastase (PMNE), and coagulofibrinolytic factors (thrombin-antithrombin III complex [TAT], D-dimer). Postoperative clinical response was evaluated on the basis of respiratory index, blood loss, and the postoperative and preoperative body-weight percent ratio. There were no significant differences between the groups in the plasma concentrations of IL-6, IL-10, C3a, PMNE, TAT, or D-dimer. Plasma IL-8 concentrations were below the assay detection limits at all time points in both groups. Clinical variables did not differ significantly between the groups. In conclusion, PMEA-coated CPB circuits are as biocompatible as heparin-coated CPB circuits and prevent postoperative organ dysfunction in patients undergoing elective CABG with CPB. (Ann Thorac Cardiovasc Surg 2003; 9: 22-28)
Key words: poly2methoxyethylacrylate (PMEA), cardiopulmonary bypass (CPB), coronary artery bypass grafting (CABG)
From Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan
Received June 13, 2002; accepted for publication November 12, 2002
Address reprint requests to Manabu Noguchi, MD: Department of Cardiovascular Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501 Japan.
This paper was presented on February 16, 2002 at the 32nd Annual Meeting of the Japan