Key result
Phosphorylcholine-coated ECC systems failed to attenuate the inflammatory response to cardiopulmonary bypass, with higher IL-10 (P=0.002) and lower IL-6 (P=0.001) at T2 compared to noncoated systems.
Why the study?
Do phosphorylcholine-coated extracorporeal circulation systems reduce oxidative stress and inflammatory markers in patients undergoing CABG?
RCT (n=32)
Randomly assigned
Do phosphorylcholine-coated extracorporeal circulation systems reduce oxidative stress and inflammatory markers in patients undergoing CABG?
Phosphorylcholine-coated extracorporeal circulation systems do not attenuate the inflammatory response to cardiopulmonary bypass during CABG.
PCC circuits did not blunt oxidative or inflammatory responses in this small CABG study; leaves open whether coated ECC systems confer meaningful clinical benefit.
Introduction. Extracorporeal circulation (ECC) related systemic oxidative stress is a well‐known entity but the underlying mechanisms are not clearly described. Our aim was to investigate the relation between the oxidative stress indices, inflammatory markers, and phosphorylcholine‐coated (PCC) ECC systems. Patients and Methods. Thirty‐two consecutive coronary artery bypass grafting (CABG) cases were randomly assigned to Group I (PCC, n = 18) and Group II (noncoated, n = 14) ECC circuits. Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Tumor Necrosis Factor‐α (TNF‐α), Interleukin‐1β (IL‐β), Interleukin‐6 (IL‐6), Interleukin‐8 (IL‐8), Interleukin‐10 (IL‐10), and Procalcitonin (PCT) levels were measured at 5 different time points. The association between the oxidative indices levels and PCC system used was analyzed. Results. In Group I TOS and TAS statuses were increased at T1, T2, T3, and T4, while IL‐10 and TNF‐α levels accompanied those raises only at T2 (Group I‐Group II, 4.73 ± 2.04 versus 2.79 ± 0.63, p = 0.002, and 30.56 ± 8.11 versus 23.97 ± 7.8, p = 0.031, resp.). In contrast, mean TAS and TOS levels were similar to baseline at all time points in Group II but IL‐6 and IL‐8 levels were increased at T2 (Group I‐Group II, 16.84 ± 5.63 versus 44.81 ± 17.0, p = 0.001, and 38.88 ± 9.8 versus 46.14 ± 9.25, p = 0.038, resp.). Conclusion. Even coated ECC systems are still incapable of attenuating the inflammatory response to cardiopulmonary bypass (CPB).
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Hatemi et al. (2016) conducted an RCT in Coronary artery bypass grafting (CABG) (n=32). Phosphorylcholine-coated (PCC) extracorporeal circulation (ECC) systems vs. Noncoated ECC circuits was evaluated on Oxidative stress indices and inflammatory markers (TAS, TOS, TNF-α, IL-1β, IL-6, IL-8, IL-10, PCT). Phosphorylcholine-coated ECC systems failed to attenuate the inflammatory response to cardiopulmonary bypass, with higher IL-10 (P=0.002) and lower IL-6 (P=0.001) at T2 compared to noncoated systems.
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