| Autor: |
Roberts TR; From the The Geneva Foundation, Tacoma, Washington., Harea GT; From the The Geneva Foundation, Tacoma, Washington., Singha P; College of Engineering, University of Georgia, Athens, Georgia., Sieck KN; From the The Geneva Foundation, Tacoma, Washington., Beely BM; From the The Geneva Foundation, Tacoma, Washington., Wendorff DS; From the The Geneva Foundation, Tacoma, Washington., Choi JH; From the The Geneva Foundation, Tacoma, Washington., Ande S; School of Mathematics, Science and Engineering, University of the Incarnate Word, San Antonio, Texas., Handa H; College of Engineering, University of Georgia, Athens, Georgia., Batchinsky AI; From the The Geneva Foundation, Tacoma, Washington. |
| Abstrakt: |
Coagulation management is the leading challenge during extracorporeal life support (ECLS) due to shear stress and foreign-surface-induced coagulation disturbance during circulation. A nonadhesive, liquid-infused coating called tethered liquid perfluorocarbon (TLP) was developed to prevent adhesion of blood on medical materials. We investigated the novel application of TLP to commercial ECLS circuits compared with standard heparin-coated circuits in vivo in anesthetized swine for 6 hours veno-venous ECLS (1 L/min blood flow) without systemic anticoagulation (n = 3/group). We hypothesized that TLP coating permits heparin-free circulation without untoward effects while reducing thrombus deposition compared with controls. Vital signs, respiration, gas transfer, coagulation, and histology were assessed. Scanning electron microscopy (SEM), elemental mapping, and digital imaging were used to assess thrombus deposition after circulation. There were no group differences in vitals, gas exchange, coagulation, and histology. In both groups, ECLS enabled a decrease in minute volume and end-tidal CO2, with concomitant increase in pH (p < 0.05). Scanning electron microscopy and digital imaging revealed significant thrombus on heparin-coated membranes, which was reduced or absent on TLP-coated materials. Tethered liquid perfluorocarbon permitted heparin-free ECLS without altering device performance and prevented thrombus deposition versus immobilized heparin. Pending multiday in vivo testing, TLP is a promising biomaterial solution to eliminate anticoagulation requirements during ECLS. |
