Cardiopulmonary bypass (CPB) is dependent on materials foreign to the patie
nt for its successful application. When blood comes into contact with these
so-called biomaterials, an inappropriate inflammatory response, which can
be life-threatening in some patients, may develop. The reason for this inap
propriate activation of host defence mechanisms is not entirely clear, howe
ver a number of strategies have evolved over the years to minimize this unw
anted sequelae of CPB. These strategies include surface coating of the mate
rials of the circuit, using new materials thought to improve biocompatibili
ty, and using a number of pharmacological interventions designed to suppres
s the inflammatory response. Recently, there has been some evidence which i
ndicates that the plasticizer employed in the polyvinyl chloride (PVC) tubi
ng of the CPB circuit may play a part in the development of the inflammator
y response. The work described in this paper tends to support this thesis.
These studies showed that by washing the plasticizer from the surface of th
e PVC tubing, the biocompatibility, as reflected in the upregulation of CID
11b on the surface of neutrophils, was enhanced. Furthermore, the use of no
n-plasticized substitutes for PVC had a similar effect. The benefit from re
moving the plasticizer was similar to that gained from surface coating with
heparin, one of the conventional approaches to reducing the inflammatory r
esponse to CPB.