In vitro hemocompatibility screening of a slippery liquid impregnated surface coating for extracorporeal organ support applications.

IN vitro studies; ARTIFICIAL blood circulation; MEDICAL equipment contamination; SCANNING electron microscopy; EXTRACORPOREAL membrane oxygenation; BLOOD coagulation; EXTRACORPOREAL carbon dioxide removal; BIOFILMS; BIOMEDICAL materials; VINYL chloride; MATERIALS testing; RESEARCH funding; DESCRIPTIVE statistics; POLYMERS; FIBRINOGEN; BLOOD testing; SURFACE properties; DATA analysis software; SURFACE tension; FOREIGN bodies; PREVENTION

Introduction: Clot formation, infection, and biofouling are unfortunate but frequent complications associated with the use of blood-contacting medical devices. The challenge of blood-foreign surface interactions is exacerbated during medical device applications involving substantial blood contact area and extended duration of use, such as extracorporeal life support (ECLS). We investigated a novel surface modification, a liquid-impregnated surface (LIS), designed to minimize protein adsorption and thrombus development on medical plastics. Methods: The hemocompatibility and efficacy of LIS was investigated first in a low-shear model with LIS applied to the lumen of blood incubation vials and exposed to human whole blood. Additionally, LIS was evaluated in a 6 h ex vivo circulation model with swine blood using full-scale ECLS circuit tubing and centrifugal pumps with clinically relevant flow rate (1.5 L/min) and shear conditions for extracorporeal carbon dioxide removal. Results: Under low-shear, LIS preserved fibrinogen concentration in blood relative to control polymers (+40 ± 6 mg/dL vs polyvinyl chloride, p <.0001), suggesting protein adsorption was minimized. A fibrinogen adhesion assay demonstrated a dramatic reduction in protein adsorption under low shear (87% decrease vs polyvinyl chloride, p =.01). Thrombus deposition and platelet adhesion visualized by scanning electron microscopy were drastically reduced. During the 6 h ex vivo circulation, platelets in blood exposed to LIS tubing did not become significantly activated or procoagulant, as occurred with control tubing; and again, thrombus deposition was visually reduced. Conclusions: A LIS coating demonstrated potential to reduce thrombus formation on medical devices. Further testing is needed specialized to clinical setting and duration of use for specific medical target applications. [ABSTRACT FROM AUTHOR]

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