Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

Open Access

In vivo leucocyte-endothelial cell interaction induced by extracorporeal circulation: reduction by a coated tube system

  • M Kamler1,
  • T Chatterjee1,
  • H Jakob1,
  • A Stemberger2,
  • MM Gebhard1 and
  • S Hagl1
Critical Care19993(Suppl 2):P04

DOI: 10.1186/cc315

Published: 2 March 1999

Objectives

The clinical complications of extracorporeal blood circulation (EBC) have been linked to disturbances in the microcirculation. In previous experiments we found in vivo an increased L/E cell interaction following EBC. As a therapeutical approach to prevent these deleterious effects a new agent to coat the tubing system, was used.

Methods

Intravital fluorescence microscopy was used on the dorsal skinfold chamber preparation in syrian golden hamsters. EBC was introduced via a micro-roller pump (1 ml/min) and a 60 cm silicon tube (1 mm inner diameter) shunted between the carotid artery and the jugular vein. Experiments were performed in chronically instrumented, awake animals (age: 10-14 weeks, weight: 65-75 g). Control tubes were uncoated, for the experiment a PEG-Hirudin-Iloprost® coating was used.

Results

Isovolemic EBC for 20 min resulted in an increase in rolling and adherent leukocytes in postcapillary venules. Micro- and macrohemodynamic parameters and functional capillary density were not affected. The use of the coated tube system resulted in a less pronounced induction of leucocyte/endothelial cell interaction. (Table)

Experiment

 

Baseline

30 min

4 h

24 h

EBC 20 min

Roller (%)

9 ± 2

19 ± 4*

36 ± 5*

15 ± 3*

Control

Sticker (mm2)

24± 26

125 ± 46*

260 ± 51*

330 ± 130*

EBC 20 min

Roller (%)

9 ± 3

13 ± 8

24 ± 12*#

11 ± 3

Coated tube

Sticker (mm2)

28 ± 25

42 ± 42

139 ± 11

194 ± 152*#

Data are means ± SD; n = 7 in each group; * P < 0.05 BL vs TP; P < 0.05 Control vs Exp.

Conclusions

L/E interaction in the microcirculation has been established as an indicator of the systemic activation induced by blood contact to synthetic surfaces during EBC. Coating the extra-corporeal circuit reduced the increase in L/E interaction probably as a result of a attenuated activation of the coagulation-fibrinolytic system including a reduced platelet activation.

Authors’ Affiliations

(1)
Department of Cardiac and Exp. Surgery, University of Heidelberg, INF 110
(2)
Department of Exp. Surgery TU Muenchen, University of Heidelberg

Copyright

© Current Science Ltd 1999

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