Sylvia Charles J, Wagel Molly A, Giare-Patel Kamna, Spangler Taylor A, Breznock Eugene M, Gupta Nisha
1 BioSurg, Inc., Winters, CA, USA.
2 Teleflex Incorporated, Reading, PA, USA.
J Vasc Access. 2018 Nov;19(6):644-650. doi: 10.1177/1129729818769033. Epub 2018 Apr 22.
: This study compared an antimicrobial and anti-thrombogenic peripherally inserted central catheter treated with a chlorhexidine-based technology, a peripherally inserted central catheter with bulk distributed fluoro-oligomers, and a poly 2-methoxyethyl acrylate-based peripherally inserted central catheter to an untreated peripherally inserted central catheter (control) in an ovine model at 14 and 30 days post-implant.
: One of four types of peripherally inserted central catheters was surgically implanted into the left jugular vein of each of 18 sheep for 14 or 30 days. Blood analysis consisted of complete blood counts, serum chemistries, and coagulation (fibrinogen, prothrombin time, and partial thromboplastin time) profiles. Sheep were sacrificed to examine the vein and thorax. Histological analysis was performed on serial catheter sections using standard microscopy on hematoxylin and eosin-stained tissues.
: All catheters developed fibroblastic sleeves at both 14 and 30 days. The chlorhexidine-peripherally inserted central catheter showed a 64% lower mean fibroblastic sleeve weight and a 66% shorter mean fibroblastic sleeve length compared to the untreated control at 14 days. By 30 days, compared to untreated control, the chlorhexidine-peripherally inserted central catheter showed 81% lower mean fibroblastic sleeve weight with 75% shorter mean fibroblastic sleeve length, the fluoro-oligomer-peripherally inserted central catheter showed 54% lower mean sheath weight with 40% shorter mean fibroblastic sleeve length, and the poly 2-methoxyethyl acrylate-peripherally inserted central catheter had 41% lower mean fibroblastic sleeve weight with 57% lower fibroblastic sleeve length.
: Among the three anti-thrombogenic peripherally inserted central catheter technologies, the chlorhexidine-peripherally inserted central catheter had the smallest fibroblastic sleeves, followed by the fluoro-oligomer-peripherally inserted central catheter, poly 2-methoxyethyl acrylate-peripherally inserted central catheter, and control peripherally inserted central catheter.
本研究在植入后14天和30天的绵羊模型中，将一种采用基于洗必泰技术处理的抗菌抗血栓外周插入中心静脉导管、一种带有大量分布氟低聚物的外周插入中心静脉导管、一种基于聚2-甲氧基乙基丙烯酸酯的外周插入中心静脉导管与未处理的外周插入中心静脉导管（对照）进行比较。
将四种类型的外周插入中心静脉导管之一通过手术植入18只绵羊每只的左颈静脉，持续14天或30天。血液分析包括全血细胞计数、血清化学分析以及凝血（纤维蛋白原、凝血酶原时间和部分凝血活酶时间）指标。对绵羊实施安乐死以检查静脉和胸腔。使用苏木精和伊红染色组织的标准显微镜对导管连续切片进行组织学分析。
所有导管在14天和30天时均形成了纤维母细胞套。与未处理的对照组相比，洗必泰外周插入中心静脉导管在14天时平均纤维母细胞套重量降低了64%，平均纤维母细胞套长度缩短了66%。到30天时，与未处理的对照组相比，洗必泰外周插入中心静脉导管平均纤维母细胞套重量降低了81%，平均纤维母细胞套长度缩短了75%；氟低聚物外周插入中心静脉导管平均鞘重量降低了54%，平均纤维母细胞套长度缩短了40%；聚2-甲氧基乙基丙烯酸酯外周插入中心静脉导管平均纤维母细胞套重量降低了41%，纤维母细胞套长度降低了57%。
在三种抗血栓外周插入中心静脉导管技术中，洗必泰外周插入中心静脉导管形成的纤维母细胞套最小，其次是氟低聚物外周插入中心静脉导管、聚2-甲氧基乙基丙烯酸酯外周插入中心静脉导管和对照外周插入中心静脉导管。
