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Relationship Between Central Venous Catheter Protein Adsorption and Water Infused Surface Protection Mechanisms

机译：中心静脉导管蛋白吸附与水注入表面保护机制的关系

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Abstract Central venous catheters (CVCs) are implanted in the majority of dialysis patients despite increased patient risk due to thrombotic occlusion and biofilm formation. Current solutions remain ineffective at preventing these complications and treatment options are limited and often harmful. We present further analysis of the previously proposed water infused surface protection (WISP) technology, an active method to reduce protein adsorption and effectively disrupt adsorbed protein sheaths on the inner surface of CVCs. A WISP CVC is modeled by a hollow fiber membrane (HFM) in a benchtop device which continuously infuses a saline solution across the membrane wall into the blood flow, creating a blood‐free boundary layer at the lumen surface. Total protein adsorption is measured under various experimental conditions to further test WISP performance. The WISP device shows reduced protein adsorption as blood and WISP flow rates increase ( P ??0.040) with up to a 96% reduction in adsorption over the no WISP condition. When heparin is added to the WISP flow, protein adsorption (0.097[+0.035/–0.055] μg/mm 2 ) is reduced when compared to both bolus administration and nondoped WISP, 0.406(+0.056/–0.065) μg/mm 2 ( P ?=?0.001) and 0.191 (+0.076/–0.126) ( P ?=?0.029), respectively. Additionally, when heparinized WISP is applied to a preadsorbed protein layer, 0.375(+0.114/–0.164) μg/mm 2 , it displays the ability to reduce the previously‐adsorbed protein, 0.186(+0.058/–0.084) μg/mm 2 ( P ?=?0.0012), suggesting aptitude for intermittent treatments. The WISP technology not only shows the ability to reduce protein adsorption, but also the ability to remove preadsorbed material by effectively delivering drugs to the point of adsorption; functionalities that could greatly improve clinical outcomes.
机译：摘要植物中央静脉导管（CVC）在大多数透析患者中​​植入了大多数透析患者，尽管由于血栓形成闭塞和生物膜形成增加了患者风险。目前的解决方案在预防这些并发症和治疗方案方面保持无效，并且通常有害。我们进一步分析了先前提出的水注入表面保护（WISP）技术，一种活性方法，以减少蛋白质吸附，有效地破坏CVC内表面上的吸附蛋白质护套​​。 WISP CVC由间隙装置中的中空纤维膜（HFM）建模，该台式装置中的玻璃壁在膜壁上连续地注入血流，在腔表面处产生无血的边界层。在各种实验条件下测量总蛋白质吸附，以进一步测试WISP性能。 WISP装置显示出降低的蛋白质吸附，随着血液和WISP流速的增加（P？<0.040），在NO WISP条件下可减少吸附96％。当肝素添加到WISP流中时，与推注给药和NondOped Wisp相比，蛋白质吸附（0.097 [+ 0.035 / -0.055]μg/ mm 2），0.406（+ 0.056 / -0.065）μg/ mm 2（ p？=Δ0.001）和0.191（+ 0.076 / -0.126）（p？= 0.029）。另外，当肝素化的WISP施加到预充构的蛋白质层时，0.375（+ 0.114 / -0.164）μg/ mm 2，它显示减少预先吸附蛋白的能力，0.186（+ 0.058 / -0.084）μg/ mm 2 （P？= 0.0012），表明适当的间歇处理。 WISP技术不仅显示出降低蛋白质吸附的能力，而且还可以通过有效地将药物递送到吸附点来除去预充血材料的能力;能够大大改善临床结果的功能。

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