The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass

Bernadette T. Nutter, Alfred H. Stammers, Ryan G. Schmer, Rebecca L. Ahlgren, Tunisia A. Ellis, Chen Gao, Hunter B. Holcomb, Lynette M Smith, Tab Burkeman

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Cardiopulmonary bypass (CPB) exposes blood to artificial surfaces, resulting in mechanical damage to the formed elements of the blood. The purpose of this study was to examine the effect of poly (2-methoxyethylacrylate) coating (PMEA, X-Coating™) on coagulation and inflammation under various prime conditions. An in vitro analysis was conducted utilizing fresh whole human blood (2 units) and a CPB circuit (n = 18) consisting of a venous reservoir, oxygenator, and arterial filter. Nine nontreated circuits were used in a control group (CTR) and an equal number of tip-to-tip PMEA circuits for treatment (TRT). Each group was divided into three subgroups based upon prime: crystalloid, hetastarch (6%), and albumin (5%). CPB was conducted with a hematocrit 30% ± 2, temperature 37°C ± 1, and a flow of 4L/min. Samples were collected at 0, 60, 120, and 240 minute intervals. Endpoint measurements included thromboelastograph index (TI), and markers of inflammation and coagulation. The TI was significantly depressed in both groups when hetastarch was used in the prime. The TRT had significantly higher TI levels in both the crystalloid (0.3 ± 0.1 vs. -3.3±-1.2, P < .05) and albumin (0.6 ± 0.2 vs-3.9± -1.1. P < .03) subgroups compared to CTR groups. Platelet count was significantly higher in TRT as compared to CTR groups, except for both hetastarch groups. SEM demonstrated significant fibrin deposition on nontreated circuitry but little to no detection in the TRT group. In conclusion, both surface coating and prime components significantly effect coagulation, with PMEA circuits resulting in more favorable preservation of function.

Original languageEnglish (US)
Pages (from-to)36-43
Number of pages8
JournalJournal of Extra-Corporeal Technology
Volume36
Issue number1
StatePublished - Mar 1 2004

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Hydroxyethyl Starch Derivatives
Cardiopulmonary Bypass
Albumins
Control Groups
Inflammation
Oxygenators
Blood Substitutes
Vascular Access Devices
Fibrin
Platelet Count
Hematocrit
Temperature
crystalloid solutions

Keywords

  • Biocompatibility
  • Colloid oncotic pressure
  • Protein adsorption
  • X-coating (PMEA)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nutter, B. T., Stammers, A. H., Schmer, R. G., Ahlgren, R. L., Ellis, T. A., Gao, C., ... Burkeman, T. (2004). The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass. Journal of Extra-Corporeal Technology, 36(1), 36-43.

The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass. / Nutter, Bernadette T.; Stammers, Alfred H.; Schmer, Ryan G.; Ahlgren, Rebecca L.; Ellis, Tunisia A.; Gao, Chen; Holcomb, Hunter B.; Smith, Lynette M; Burkeman, Tab.

In: Journal of Extra-Corporeal Technology, Vol. 36, No. 1, 01.03.2004, p. 36-43.

Research output: Contribution to journalArticle

Nutter, BT, Stammers, AH, Schmer, RG, Ahlgren, RL, Ellis, TA, Gao, C, Holcomb, HB, Smith, LM & Burkeman, T 2004, 'The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass', Journal of Extra-Corporeal Technology, vol. 36, no. 1, pp. 36-43.
Nutter BT, Stammers AH, Schmer RG, Ahlgren RL, Ellis TA, Gao C et al. The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass. Journal of Extra-Corporeal Technology. 2004 Mar 1;36(1):36-43.
Nutter, Bernadette T. ; Stammers, Alfred H. ; Schmer, Ryan G. ; Ahlgren, Rebecca L. ; Ellis, Tunisia A. ; Gao, Chen ; Holcomb, Hunter B. ; Smith, Lynette M ; Burkeman, Tab. / The Rheological Effects of X-Coating™ with Albumin and Hetastarch on Blood during Cardiopulmonary Bypass. In: Journal of Extra-Corporeal Technology. 2004 ; Vol. 36, No. 1. pp. 36-43.
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abstract = "Cardiopulmonary bypass (CPB) exposes blood to artificial surfaces, resulting in mechanical damage to the formed elements of the blood. The purpose of this study was to examine the effect of poly (2-methoxyethylacrylate) coating (PMEA, X-Coating™) on coagulation and inflammation under various prime conditions. An in vitro analysis was conducted utilizing fresh whole human blood (2 units) and a CPB circuit (n = 18) consisting of a venous reservoir, oxygenator, and arterial filter. Nine nontreated circuits were used in a control group (CTR) and an equal number of tip-to-tip PMEA circuits for treatment (TRT). Each group was divided into three subgroups based upon prime: crystalloid, hetastarch (6{\%}), and albumin (5{\%}). CPB was conducted with a hematocrit 30{\%} ± 2, temperature 37°C ± 1, and a flow of 4L/min. Samples were collected at 0, 60, 120, and 240 minute intervals. Endpoint measurements included thromboelastograph index (TI), and markers of inflammation and coagulation. The TI was significantly depressed in both groups when hetastarch was used in the prime. The TRT had significantly higher TI levels in both the crystalloid (0.3 ± 0.1 vs. -3.3±-1.2, P < .05) and albumin (0.6 ± 0.2 vs-3.9± -1.1. P < .03) subgroups compared to CTR groups. Platelet count was significantly higher in TRT as compared to CTR groups, except for both hetastarch groups. SEM demonstrated significant fibrin deposition on nontreated circuitry but little to no detection in the TRT group. In conclusion, both surface coating and prime components significantly effect coagulation, with PMEA circuits resulting in more favorable preservation of function.",
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AB - Cardiopulmonary bypass (CPB) exposes blood to artificial surfaces, resulting in mechanical damage to the formed elements of the blood. The purpose of this study was to examine the effect of poly (2-methoxyethylacrylate) coating (PMEA, X-Coating™) on coagulation and inflammation under various prime conditions. An in vitro analysis was conducted utilizing fresh whole human blood (2 units) and a CPB circuit (n = 18) consisting of a venous reservoir, oxygenator, and arterial filter. Nine nontreated circuits were used in a control group (CTR) and an equal number of tip-to-tip PMEA circuits for treatment (TRT). Each group was divided into three subgroups based upon prime: crystalloid, hetastarch (6%), and albumin (5%). CPB was conducted with a hematocrit 30% ± 2, temperature 37°C ± 1, and a flow of 4L/min. Samples were collected at 0, 60, 120, and 240 minute intervals. Endpoint measurements included thromboelastograph index (TI), and markers of inflammation and coagulation. The TI was significantly depressed in both groups when hetastarch was used in the prime. The TRT had significantly higher TI levels in both the crystalloid (0.3 ± 0.1 vs. -3.3±-1.2, P < .05) and albumin (0.6 ± 0.2 vs-3.9± -1.1. P < .03) subgroups compared to CTR groups. Platelet count was significantly higher in TRT as compared to CTR groups, except for both hetastarch groups. SEM demonstrated significant fibrin deposition on nontreated circuitry but little to no detection in the TRT group. In conclusion, both surface coating and prime components significantly effect coagulation, with PMEA circuits resulting in more favorable preservation of function.

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