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Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

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

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)

Table 1

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.

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Kamler, M., Chatterjee, T., Jakob, H. et al. In vivo leucocyte-endothelial cell interaction induced by extracorporeal circulation: reduction by a coated tube system. Crit Care 3, P04 (1999). https://doi.org/10.1186/cc315

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Keywords

  • Cell Interaction
  • Extracorporeal Circulation
  • Golden Hamster
  • Syrian Golden Hamster
  • Postcapillary Venule