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Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

  • Meeting abstract
  • Open Access

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

  • 1,
  • 1,
  • 1,
  • 2,
  • 1 and
  • 1
Critical Care19993 (Suppl 2) :P04

https://doi.org/10.1186/cc315

  • Published:

Keywords

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

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, Heidelberg, 69120, Germany
(2)
Department of Exp. Surgery TU Muenchen, University of Heidelberg, Germany

Copyright

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