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用于体外膜肺氧合抗凝的聚氯乙烯上的比伐卢定水凝胶涂层

Bivalirudin-hydrogel coatings of polyvinyl chloride on extracorporeal membrane oxygenation for anticoagulation.

作者信息

Gao Wenqing, Shen Hechen, Chang Yun, Tang Qin, Li Tong, Sun Di

机构信息

Department of Cardiac Center, Tianjin Third Central Hospital, Tianjin, China.

Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China.

出版信息

Front Cardiovasc Med. 2023 Dec 15;10:1301507. doi: 10.3389/fcvm.2023.1301507. eCollection 2023.

Abstract

INTRODUCTION

Thromboembolic events associated with extracorporeal membrane oxygenation (ECMO) in clinical treatment are typical. Heparin coating has been widely employed as a surface modification strategy for ECMO tubes. However, its clinical application is often accompanied by unavoidable complications due to its mechanism of action. As a direct thrombin inhibitor with a single target, Bivalirudin (BV) has exhibited a lower incidence of adverse events and superior pharmacokinetic performance compared to heparin.

METHODS

A gelatin methacrylate hydrogel (GelMA) coating layer with BV was successfully synthesized on polyvinyl chloride, and the drug release ratio was close to complete release within 7 days.

RESULTS AND DISCUSSION

Simulated extracorporeal circulation experiments using roller pumps and jugular arteriovenous bypass experiments in rabbits demonstrated its outstanding anticoagulant efficacy. The systemic anticoagulant assay proved that BV hydrogel coating does not affect the coagulation level, and reduces the risk of complications such as systemic bleeding compared to intravenous injection. BV-Coating GelMA hydrogel tube has exhibited good biocompatibility and significantly improved anticoagulant performance, making it an optimal choice for surface materials used in blood-contacting medical devices.

摘要

引言

临床治疗中与体外膜肺氧合(ECMO)相关的血栓栓塞事件很典型。肝素涂层已被广泛用作ECMO管道的表面改性策略。然而,由于其作用机制,其临床应用常伴有不可避免的并发症。作为一种具有单一靶点的直接凝血酶抑制剂,比伐卢定(BV)与肝素相比,不良事件发生率更低,药代动力学性能更优。

方法

在聚氯乙烯上成功合成了含BV的甲基丙烯酸明胶水凝胶(GelMA)涂层,药物释放率在7天内接近完全释放。

结果与讨论

使用滚轴泵进行的模拟体外循环实验以及在兔子身上进行的颈动静脉旁路实验证明了其出色的抗凝效果。全身抗凝试验证明,BV水凝胶涂层不影响凝血水平,与静脉注射相比,降低了全身出血等并发症的风险。BV涂层GelMA水凝胶管具有良好的生物相容性,抗凝性能显著提高,使其成为用于血液接触医疗器械的表面材料的最佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71c1/10754995/cb80358d7f3e/fcvm-10-1301507-g001.jpg

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