Synthetic Material Abdominal Swabs Reduce Activation of Platelets and Leukocytes Compared to Cotton Materials.
Katharina GerlingLisa Maria HerrmannChristoph SalewskiMelanie WolfPia MüllerbaderDorothea Siegel-AxelHans Peter WendelChristian SchlensakMeltem Avci-AdaliSandra StoppelkampPublished in: Biomolecules (2021)
During surgical procedures, cotton abdominal swabs with their high absorptive capacity and malleability are used to retain organs and absorb blood or other body fluids. Such properties of the natural material cotton are advantageous for most operations, but in cardiopulmonary bypass (CPB) surgery, a high blood volume can accumulate in the thoracic cavity that is quickly retransfused via the heart-lung machine (HLM). This common practice is supposed to be safe due to the high anticoagulation. However, in vitro analyses showed that blood cells and plasma proteins were activated despite a high anticoagulation, which can propagate especially an inflammatory response in the patient. Thus, we investigated patients' blood during CPB surgery for inflammatory and coagulation-associated activation after contact to the HLM and either cotton or synthetic abdominal swabs. Contact with cotton significantly increased thrombocyte and neutrophil activation measured as β-thromboglobulin and PMN-elastase secretion, respectively, compared to synthetic abdominal swabs. Both inflammatory cytokines, interleukin (IL) 1β and IL6, were also significantly increased in the cotton over the synthetic patient group, while SDF-1α was significantly lower in the synthetic group. Our data show for the first time that cotton materials can activate platelets and leukocytes despite a high anticoagulation and that this activation is lower with synthetic materials. This additional activation due to the material on top of the activation exerted by the tissue contact that blood is exposed to during CPB surgery can propagate further reactions in patients after surgery, which poses a risk for this already vulnerable patient group.
Keyphrases
- end stage renal disease
- minimally invasive
- inflammatory response
- chronic kidney disease
- ejection fraction
- newly diagnosed
- coronary artery bypass
- venous thromboembolism
- case report
- prognostic factors
- peritoneal dialysis
- primary care
- heart failure
- acute coronary syndrome
- surgical site infection
- deep learning
- oxidative stress
- high resolution
- quality improvement
- electronic health record
- coronary artery disease
- atomic force microscopy