Ex vivo testing of heparin-coated extracorporeal circuits: bovine experiments

Int J Artif Organs. 1998 May;21(5):291-8.

Abstract

In this study the intrinsic thrombogenicity of the extracorporeal circuits and the benefit of heparin-bonded circuits in an extracorporeal life support system without full systemic heparinization and with minimal interference of the so called material-independent factors was tested in four calves. In two circuits (group A) all blood-contacting surfaces were coated with end-point-attached heparin and the other two were non-coated (group B). Under standardized conditions the calves were perfused at a blood flow rate of 2 L/min. After only one bolus injection of heparin (250 IU/kg body weight) before cannulation, plasma heparin activity rapidly decreased in both groups: half life of about 55 minutes. This decrease of the heparin activity was accompanied by a fall of the activated clotting time (ACT) level to baseline values. The experiments using a heparin-coated circuit, had a runtime of more than 360 minutes, whereas the experiments using a non-coated circuit had to be terminated after a runtime of 255 minutes, because massive fibrin formation was noticed in the circuit. This formation was accompanied by a rapid increase in the line pressure, measured just before the inlet of the oxygenator. The macroscopic inspections after terminating the experiments and rinsing the circuit showed a clean circuit in group A. The fibrinopeptide A (FPA) level increased faster during perfusion with the non-coated circuit than in the heparin coated circuit. Lung histopathological examinations of the lungs of the animals in group A showed no fibrin deposition, whereas most of the blood vessels of the lung preparations of the animals in group B were partially or completely occluded with fibrin. These results suggest that heparin-bonding greatly reduces the thrombogenicity of the extracorporeal circuit, and therefore it can reduce the need for systemic heparinization in an extracorporeal life support system.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Anticoagulants / therapeutic use
  • Antifibrinolytic Agents* / blood
  • Catheterization, Peripheral
  • Cattle
  • Extracorporeal Circulation / instrumentation*
  • Extracorporeal Circulation / methods
  • Extracorporeal Membrane Oxygenation / instrumentation
  • Fibrin / analysis
  • Fibrinopeptide A / analysis
  • Heparin* / blood
  • Lung / blood supply
  • Lung / pathology
  • Surface Properties
  • Thrombosis / prevention & control
  • Whole Blood Coagulation Time

Substances

  • Anticoagulants
  • Antifibrinolytic Agents
  • Fibrinopeptide A
  • Fibrin
  • Heparin