ABSTRACT
Blood contact with artificial device surfaces and mechanical trauma are two major factors for haemolysis. Poly(2-methoxyethyl acrylate) (PMEA) is an amphiphilic polymer with a polyethylene chain that is hydrophobic and a mildly hydrophilic tail. PMEA coating has showed positive effects on protein adsorption, platelet loss, platelet aggregation and post-operative bleeding in previous studies. In this study, effects of poly(2-metoxyethyl acrylate) (PMEA)-coated oxygenators on haemolysis was investigated. PMEA-coated (SX18-Capiox) oxygenators were used. Desorbed erythrocyte, free haemoglobin indirect bilirubin and total bilirubin quantities from fibre samples of oxygenators were studied. Erythrocyte, total bilirubin and direct bilirubin values were measured from blood aliquots taken in five different times during cardiopulmonary by-pass (CPB); baseline (T1), during CPB (T2), at the end of CPB (T3), after protamine injection (T4) and in intensive care (T5). In both coated and non-coated oxygenators haemolysis rate was in clinically acceptable safety range. Average desorbed free haemoglobin was 6663 mg/dl from coated and 29.405 mg/dl from non-coated fibres. Average desorbed total bilirubin was 0.0068 mg/dl from coated and 0.023 mg/dl from noncoated fibres. We observed less haemolysis, as reflected by lower desorbed free haemoglobin and indirect bilirubin from coated oxygenators and less decrease in blood erythrocyte number. Blood bilirubin concentration was low in the coated group when compared to the control group. This study describes the relationship between PMEA coating and haemolysis at the blood contacting surface. PMEA coating reduces red blood cell damage during extracorporeal circulation.
Subject(s)
Acrylates/pharmacology , Coated Materials, Biocompatible , Erythrocytes/drug effects , Oxygenators, Membrane , Polymers/pharmacology , Bilirubin/blood , Erythrocyte Count , Erythrocytes/physiology , Hemoglobins/analysis , Hemolysis , Humans , In Vitro Techniques , Time FactorsABSTRACT
In this study, controllability, safety, blood cell depletion, and hemolysis of a pulsatile roller pump in high-risk patients was evaluated. Sarns 8000 roller pump (Sams, Terumo CVS, Ann Arbor, MI, USA) with a pulsatile control module was used as arterial pump in a clinical setting. Forty patients undergoing elective open heart surgery with high-risk either having chronically obstructive pulmonary disease or chronic renal failure were randomly included in the study to be operated on using pulsatile perfusion or non-pulsatile perfusion. Blood samples were withdrawn at induction of anesthesia, at the time of aortic clamping and de-clamping and at 1 hour and 24 hours following cessation of the bypass. Hematocrit and plasma free hemoglobin values were measured. We observed that the pulsatile roller pump perfusion and the extracorporeal circuit used in the clinical study is safe in high-risk patients undergoing cardiopulmonary bypass. We did not face any emboli, hemolysis, or technical problems. Pulsatile roller pump perfusion with Sarns 8000 heart-lung machine is a simple and reliable technique and can be easily applied during open heart surgery.
Subject(s)
Cardiac Surgical Procedures/instrumentation , Cardiopulmonary Bypass/instrumentation , Heart Diseases/surgery , Pulsatile Flow/physiology , Adult , Aged , Cardiopulmonary Bypass/methods , Female , Heart Diseases/complications , Humans , Infusion Pumps , Kidney Failure, Chronic/complications , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Treatment OutcomeABSTRACT
A dye-ligand. Cibacron Blue F3GA. was covalently coupled with the poly(EGDMA-HEMA) microbeads. The affinity sorbent carrying 16.5 micromol Cibacron Blue F3GA per gram polymer was then used to remove bilirubin from human plasma in a packed-bed column system. Bilirubin adsorption from human plasma on the unmodified poly(EGDMA-HEMA) microbeads was 0.32 mg/g, while much higher adsorption values, up to 24.2 mg/g, were obtained with the dye-attached microbeads. The bilirubin adsorption capacity of the microbeads decreased with an increase in the recirculation rate of plasma. Bilirubin adsorption increased with increasing temperature, and the maximum adsorption achieved at 37 degrees C (32.5 mg bilirubin/g polymer). Bilirubin molecules interacted directly with the immobilized Cibacron Blue F3GA molecules. Contribution of albumin adsorption on bilirubin adsorption was also significant.
Subject(s)
Bilirubin/blood , Absorption , Bilirubin/isolation & purification , Chromatography, Affinity , Coloring Agents , Humans , Polymethacrylic Acids , Serum Albumin/chemistry , Temperature , TriazinesABSTRACT
Cibacron Blue F3GA-immobilized poly(EGDMA-HEMA) microbeads were investigated as a specific sorbent for bilirubin removal from human plasma. The poly(EGDMA-HEMA) microbeads were prepared by a modified suspension copolymerization technique. Cibacron Blue F3GA was covalently coupled to the poly(EGDMA-HEMA) microbeads via the nucleophilic reaction between the chloride of its triazine ring and the hydroxyl groups of the HEMA molecule, under alkaline conditions. Bilirubin adsorption was investigated from hyperbilirubinemic human plasma on the poly(EGDMA-HEMA) microbeads containing different amounts of immobilized Cibacron Blue F3GA, (between 5.0-16.5 micromol/g). The non-specific bilirubin adsorption on the unmodified poly(EGDMA-HEMA) microbeads were 0.32 mg/g from human plasma. Higher bilirubin adsorption values, up to 14.8 mg/g, were obtained with the Cibacron Blue F3GA-immobilized microbeads. Bilirubin molecules interacted with these sorbents directly. Contribution of albumin adsorption on the bilirubin adsorption was pronounced. Bilirubin adsorption increased with increasing temperature.
