Blood Interaction with Synthetic Surfaces

1. Vascular endothelial cells provide a nonthrombogenic surface due to their synthesis of

a) Prostoglandins

b) Other chemical & peptides

c) Negativily charged surface

2. All other cells & synthetic surfaces initiate coagulation

3. Massive activation stimulus of CPB requires large quantities of heparin

a) Heparin inactivates Xa & IIa by enhancing action of ATIII

b) Coagulation is only inhibited at end of coagulation pathway

c) Early reactions are not inhibited

i) Kallikrein activation

ii) Complement activation

iii) White cell activation

iv) Endothelial cell activation

--> whole body inflammatory response

4. Blood contact with synthetic surfaces activates 4 primary proteins of the contact activation system

i) Factor XII

ii) Factor XI

iii) PreKallikrein

iv) HMWK

-->initiates whole body inflammatory response including

a) Intrinsic coagulation

b) Classic complement pathway

c) Fibrinolysis

d) Kinins

e) Neutrophil activation

K. C. Potger
Copyright © 2001