Bambauer R, Mestres P, Schiel R, Schneidewind J M, Latza R, Bambauer S, Sioshansi P
Institute for Blood Purification, University of Saarland, Homburg/Saar, Germany.
Ther Apher. 2000 Oct;4(5):342-7. doi: 10.1046/j.1526-0968.2000.004005342.x.
Infection, thrombosis, and stenosis are among the most frequent complications associated with blood contacting catheters. Because these problems are usually related to surface properties of the base catheter material, surface treatment processes such as ion implantation and ion beam assisted deposition (IBAD) (silver based coatings) can be used to mitigate such complications. Because these ion beam based processes affect only the near-surface region (approximately the outer 1 microm), there is little effect on bulk material properties. This study evaluated silver coated large bore catheters used for extracorporeal detoxification. In a 135 patient prospective study, 170 large bore catheters were inserted into the internal jugular or subclavian veins. Seventy-eight surface treated catheters (Spi-Argent, Spire Corporation, Bedford, MA, U.S.A.; n = 32 acute catheters, n = 46 long-term catheters) were inserted in 55 patients. Ninety-two untreated catheters placed in 80 patients served as controls (n = 40 acute catheters, n = 52 long-term catheters). After removal, the catheters were cultured for bacterial colonization using standard microbiologic assays. They also were examined using a scanning electron microscope (SEM). Bacterial colonization was observed in 7% of the treated catheters compared with 35.3% of untreated catheters. The SEM investigations showed all treated catheters to possess low thrombogenicity. Results of the study indicate that ion beam based processes can be used to improve thrombus and infection resistance of blood contacting catheters.
感染、血栓形成和狭窄是与接触血液的导管相关的最常见并发症。由于这些问题通常与基础导管材料的表面特性有关，因此可以使用诸如离子注入和离子束辅助沉积（IBAD）（银基涂层）等表面处理工艺来减轻此类并发症。由于这些基于离子束的工艺仅影响近表面区域（大约外层1微米），因此对 bulk material properties几乎没有影响。本研究评估了用于体外解毒的银涂层大口径导管。在一项135例患者的前瞻性研究中，将170根大口径导管插入颈内静脉或锁骨下静脉。55例患者插入了78根经表面处理的导管（Spi-Argent，Spire Corporation，美国马萨诸塞州贝德福德；n = 32根急性导管，n = 46根长期导管）。80例患者中放置的92根未处理导管作为对照（n = 40根急性导管，n = 52根长期导管）。拔除后，使用标准微生物检测方法对导管进行细菌定植培养。还使用扫描电子显微镜（SEM）对其进行检查。与35.3%的未处理导管相比，7%的经处理导管观察到细菌定植。SEM研究表明，所有经处理的导管均具有低血栓形成性。研究结果表明，基于离子束的工艺可用于提高接触血液导管的抗血栓和抗感染能力。
