Uncoated Polyvinyl Chloride Research Articles

Hydrophilic catheters for intermittent catheterization and occurrence of urinary tract infections. A retrospective comparative study in patients with spinal cord Injury

BackgroundNeurogenic bladder dysfunction is a major problem for spinal cord injury (SCI) patients not only due to the risk of serious complications but also because of the impact on quality of life. The main aim of this study is to compare the rate of urinary tract infection (UTI) associated with hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters among SCI patients presenting with functional neurogenic bladder sphincter disorders.MethodologyThis was a retrospective cohort study from 2005 to 2020 including adult male or female patients who have an SCI at least more than 1 month ago with neurogenic bladder dysfunction and were using intermittent catheterization (single-use hydrophilic-coated or the standard-of-care polyvinyl chloride uncoated standard catheters) at least 3 times a day to maintain bladder emptying.ResultsA total of 1000 patients were selected and recruited through a stratified random sampling technique with 467 (47.60%) patients in the uncoated catheter arm and 524 (52.60%) in the coated catheter groups. The three outcome measures, namely: symptomatic UTI, Bacteriuria, and pyuria were significantly higher in the group using uncoated polyvinyl chloride (PVC) catheters compared to hydrophilic-coated catheters at the rate of 79.60% vs.46.60%, 81.10% vs. 64.69, and 53.57% versus 41.79% respectively. Males, elder patients, longer duration, and severity of SCI were associated with increased risk of symptomatic UTI.ConclusionsThe results indicate a beneficial effect regarding clinical UTI when using hydrophilic-coated catheters in terms of fewer cases of symptomatic UTI. Bacteriuria is inevitable in patients with long-term catheterization, however, treatment should not be started unless the clinical symptoms exist. More attention should be given to the high-risk group for symptomatic UTIs.

Comparison of Superhydrophilic, Liquid-Like, Liquid-Infused, and Superhydrophobic Surfaces in Preventing Catheter-Associated Urinary Tract Infection and Encrustation.

Over the past decade, superhydrophilic zwitterionic surfaces, slippery liquid-infused porous surfaces, covalently attached liquid-like surfaces, and superhydrophobic surfaces have emerged as the most promising strategies to prevent biofouling on biomedical devices. Despite working through different mechanisms, they have demonstrated superior efficacy in preventing the adhesion of biomolecules (e.g., proteins and bacteria) compared with conventional material surfaces. However, their potential in combating catheter-associated urinary tract infection (CAUTI) remains uncertain. In this research, we present the fabrication of these four coatings for urinary catheters and conduct a comparative assessment of their antifouling properties through a stepwise approach. Notably, the superhydrophilic zwitterionic coating demonstrated the highest antifouling activity, reducing 72.3% of fibrinogen deposition and over 75% of bacterial adhesion (Escherichia coli and Staphylococcus aureus) when compared with an uncoated polyvinyl chloride (PVC) surface. The zwitterionic coating also exhibited robust repellence against blood and improved surface lubricity, decreasing the dynamic coefficient of friction from 0.63 to 0.35 as compared with the PVC surface. Despite the fact that the superhydrophilic zwitterionic and hydrophobic liquid-like surfaces showed great promise in retarding crystalline biofilm formation in the presence of Proteus mirabilis, it is worth noting that their long-term antifouling efficacy may be compromised by the proliferation and migration of colonized bacteria as they are unable to kill them or inhibit their swarming. These findings underscore both the potential and limitations of these ultralow fouling materials as urinary catheter coatings for preventing CAUTI.

Effect of Modified Silica Materials on Polyvinyl Chloride (PVC) Substrates to Obtain Transparent and Hydrophobic Hybrid Coatings

In this research, we report a simple and inexpensive way to prepare transparent and hydrophobic hybrid coatings through deposition of different silica materials on polyvinyl chloride (PVC) substrates. The silica materials were prepared using an acid-catalyzed sol–gel method at room temperature (25 ± 2 °C), using alkoxysilanes: tetraethoxysilane (TEOS), as the silica source, and ethoxydimethylvinylsilane (DMVES), triethoxyoctylsilane (OTES), and trimethoxyhexadecylsilane (HDTMES), as modifier agents. The obtained materials were characterized (either as powders or as thin films) by Fourier-transform infrared spectroscopy (FTIR), UV/Vis spectroscopy, transmission electron microscopy (TEM), thermogravimetric analysis (TGA), atomic force microscopy (AFM), spectroscopic ellipsometry (SE), and water contact-angle measurements. UV/Vis spectra showed that the PVC substrate coated with the silica material containing TEOS/DMVES/OTES had a transmittance of about 90% in the wavelength range of 650–780 nm. The water contact angles increased from 83° for uncoated PVC substrate to ~94° for PVC substrates coated with the sol–gel silica materials. These PVC films with hybrid silica coatings can be used as the materials for outdoor applications, such as energy-generating solar panel window blinds or PVC clear Windmaster outdoor blinds.

Preparation and Characterization of Some Sol-Gel Modified Silica Coatings Deposited on Polyvinyl Chloride (PVC) Substrates

Transparent and antireflective coatings were prepared by deposition of modified silica materials onto polyvinyl chloride (PVC) substrates. These materials were obtained by the sol-gel route in acidic medium, at room temperature (25 °C), using different alkoxysilanes with various functional groups (methyl, vinyl, octyl or hexadecyl). Physicochemical and microstructural properties of resulted silica materials and of thin coatings were investigated through Fourier Transforms Infrared Spectroscopy (FTIR), UV-Vis spectroscopy, Thermal Gravimetric Analysis (TGA), Dynamic Mechanical Analysis (DMA), Atomic Force Microscopy (AFM) and ellipsometric measurements. Wetting behaviors of the silica coatings were evaluated by measurement of static contact angle against water. FTIR spectra of materials confirmed the high degree of cross-linking that result from the formation of the inorganic backbone through the hydrolysis and polycondensation reactions together with the formation of the organic network. These sol-gel silica coatings showed a reduction in the reflectance (10%) compared with uncoated PVC substrate. AFM reveals that the films are uniform, and adherent to the substrate, but their morphology is strongly influenced by the chemical composition of the coating matrices. These silica coatings can be useful for potential electronic and optical devices.

An In Vitro Hemodynamic Loop Model to Investigate the Hemocytocompatibility and Host Cell Activation of Vascular Medical Devices

In this study, the hemocompatibility of tubes with an inner diameter of 5 mm made of polyvinyl chloride (PVC) and coated with different bioactive conjugates was compared to uncoated PVC tubes, latex tubes, and a stent for intravascular application that was placed inside the PVC tubes. Evaluation of hemocompatibility was done using an in vitro hemodynamic loop model that is recommended by the ISO standard 10993-4. The tubes were cut into segments of identical length and closed to form loops avoiding any gap at the splice, then filled with human blood and rotated in a water bath at 37 °C for 3 hours. Thereafter, the blood inside the tubes was collected for the analysis of whole blood cell count, hemolysis (free plasma hemoglobin), complement system (sC5b-9), coagulation system (fibrinopeptide A), and leukocyte activation (polymorphonuclear elastase, tumor necrosis factor and interleukin-6). Host cell activation was determined for platelet activation, leukocyte integrin status and monocyte platelet aggregates using flow cytometry. The effect of inaccurate loop closure was examined with x-ray microtomography and scanning electron microscopy, that showed thrombus formation at the splice. Latex tubes showed the strongest activation of both plasma and cellular components of the blood, indicating a poor hemocompatibility, followed by the stent group and uncoated PVC tubes. The coated PVC tubes did not show a significant decrease in platelet activation status, but showed an increased in complement and coagulation cascade compared to uncoated PVC tubes. The loop model itself did not lead to the activation of cells or soluble factors, and the hemolysis level was low. Therefore, the presented in vitro hemodynamic loop model avoids excessive activation of blood components by mechanical forces and serves as a method to investigate in vitro interactions between donor blood and vascular medical devices.

Biofilm formation on three different endotracheal tubes: a prospective clinical trial

BackgroundBiofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.MethodsWe compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 h of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.ResultsHigh-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14–15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06–0.59], p = 0.005, and OR 0.34 [95% CI 0.13–0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17–1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.ConclusionHigh-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed.Trial registrationClinicalTrials.gov NCT02284438. Retrospectively registered on 21 October 2014.

An effective evidence-based cleaning method for the safe reuse of intermittent urinary catheters: In vitro testing.

To determine a safe bactericidal cleaning method that does not damage urethral catheters used for intermittent catheterization. In some countries, single-use catheters are the norm; in others, the reuse of catheters is common depending on health insurance, personal preference, or individual concerns about the environment. However, no recent study of cleaning methods has been published to provide evidence for the safe reuse of catheters. Using advanced microbiological methods, a laboratory study of eight cleaning methods was conducted. Sections of uncoated polyvinylchloride (PVC) catheters were exposed to bacterial uropathogens in physiologically correct artificial urine media then tested with a range of heat, chemical, and mechanical cleaning methods. Analysis of culturable and viable but nonculturable (VBNC) bacteria was done and direct microscopy was used. Descriptive statistics were used to compare values. Heat treatments, although effective, resulted in catheter surface breakdown and damage. Ultrasonic cleaning and vinegar showed evidence of VBNC populations indicating the methods were bacteriostatic. Detergent and water wash followed by immersion in a commercially available 0.6% sodium hypochlorite solution and 16.5% sodium chloride (diluted Milton) gave consistent bactericidal results and no visible catheter damage. Combined mechanical and chemical treatment of a detergent and water wash followed by immersion in diluted Milton (the "Milton Method") provided consistent and effective cleaning of uncoated PVC catheters, showing bactericidal action for all uropathogens tested after repeated exposure. If found safe in clinical testing, this method could increase the reuse of catheters, reduce plastic waste in the environment, reduce cost, and increase patient choice.

Preparation of ZnO/Ag nanocomposite and coating on polymers for anti-infection biomaterial application

ZnO/Ag nanocomposites coated with polyvinyl chloride (PVC) were prepared by chemical reduction method, for anti-infection biomaterial application. There is a growing interest in attempts in using biomolecular as the templates to grow inorganic nanocomposites in controlled morphology and structure. By optimizing the experiment conditions, we successfully fabricated high yield of ZnO/Ag nanocomposite with full coverage of high-density polyvinyl chloride (PVC) coating. More importantly, ZnO/Ag nanocomposites were shown to significantly inhibit the growth of Staphylococcus aureus in solution. It was further shown that ZnO/Ag nanocomposites induced thiol depletion that caused death of S. aureus. The coatings were fully characterized using techniques such as scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD). Most importantly, compared to uncoated metals, the coatings on PVC promoted healthy antibacterial activity. Importantly, compared to ZnO–Ag -uncoated PVC, the ZnO/Ag nanocomposites coated was approximately triplet more effective in preventing bacteria attachment. The result of Thermal Gravimetric Analysis (TGA) indicates that, the ZnO/Ag nanocomposites are chemically stable in the temperature range from 50 to 900°C. This result, for the first time, demonstrates the potential of using ZnO/Ag nanocomposites as a coating material for numerous anti-bacterial applications.

Hyaluronan and dextran modified tubes resist cellular activation with blood contact

This study was undertaken to evaluate the effects of thin film hyaluronic acid and dextran surface coatings to blunt cellular activation in a laboratory model of extracorporeal blood circulation. The inner lumen surface of polyurethane (PU) and poly(vinyl) chloride (PVC) tubing was grafted with hyaluronic acid and dextran. Surfaces were characterized for the presence of the grafted layer using ellipsometry, atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). Persistence of the surface layer was maintained for up to 5 days of continuous exposure to shear flow using a Chandler loop apparatus. The Chandler loop method was used to study human whole blood activation activity. Whole blood aggregometry and flow cytometry measures of CD18, CD62L, CD62P, Annexin V and myeloperoxidase performed on blood samples exposed to the tubing for up to three hours were complemented by scanning electron microscopy (SEM) analysis of adherent cells and state of activation. In these studies commercial hospital products and uncoated PVC and PU tubes were used as controls. We found that hyaluranized PU and PVC conferred the greatest resistance to blood activation and that dextranization of the PU and PU tubing also provided significant diminution of the bioresponses measured. Based on our findings, we suggest that surface coating with hyaluronic acid or dextran acts as a potent shield from blood cellular activation during forms of extracorporeal circulation.

Modified Surface Coatings and their Effect on Drug Adsorption within the Extracorporeal Life Support Circuit

A recently completed study quantified the percent of fentanyl or morphine sulfate lost to uncoated polyvinylchloride (PVC) tubing or to one of two hollow fiber oxygenators within the extracorporeal life support (ECLS) circuit. The results demonstrated the majority of drug loss was due to adsorption by the PVC tubing. The purpose of this study was to determine if a tubing coating process affects fentanyl or morphine Sulfate adsorption. The goal was to quantify fentanyl or morphine sulfate lost due to adhesion within surface modified tubing. The following surface modifications were studied: 1) Maquet Safeline® (synthetic immobilized albumin); 2) Maquet Softline® (a heparin free biopassive polymer); 3) Maquet Bioline® (recombinant human albumin + heparin) (Maquet Cardiopulmonary AG, Hirrlingen, Germany); 4) Terumo X Coating™ (poly2methoxylacrylate)) (Terumo Cardiovascular Systems Corporation, Ann Arbor, MI); 5) Medtronic Carmeda® (covalently bonded heparin); and 6) Medtronic Trillium® (covalently bonded heparin) (Medtronic, Minneapolis, MN). A total of 36 individual circuits were built from the above six available modified surface coatings, for a total of six individual circuits of each coating type. Blood samples were drawn at 5 minutes, 120 minutes, and 360 minutes followed by High-Performance Liquid Chromatography to determine available circulating levels of either fentanyl or morphine sulfate. Fentanyl concentrations decreased to an average final available concentration of 35% (±5%) within the 18 circuits. Morphine sulfate however, decreased to a final available concentration of 57% (±1%) in all Maquet tubing and the Medtronic Trillium tubing, while it decreased to a final concentration of 35% (±1%) in the Medtronic Carmeda coated tubing and in the Terumo X Coating tubing. Biocompatible ECLS circuit surface coatings affected drug-adsorption and availability. Further evaluation is necessary to understand the adsorptive loss of other drugs administered to our patients while on modified surface coated ECLS circuits.

Development of amorphous carbon protective coatings on poly(vinyl)chloride

The great versatility of polymers has promoted their application in a series of ordinary situations. The development of specific devices from polymers, however, requires modifications to fit specific stipulations. In this work the surface properties of thin films grown onto polyvinylchloride (PVC) were investigated. Hydrogenated amorphous carbon films were deposited onto commercial PVC plates from acetylene and argon plasmas excited by radiofrequency (13.56 MHz, 70 W) power. The proportion of acetylene in the gas feed was varied against that of argon, keeping the total pressure constant at 2.5 Pa. Deposition time was 1800 s. Film elemental composition was analyzed by X-ray photoelectron spectroscopy, XPS. Water contact angle measurements were performed using the sessile drop technique. The root mean squared roughness was derived from 50 × 50 µm 2 surface topographic images, acquired by scanning probe microscopy. Nanoindentation and pin-on-disk techniques were employed on the determination of film hardness and sliding wear, respectively. Oxidation resistance was obtained through the etching rate of the samples in oxygen radiofrequency (1.3 Pa, 50 W) plasmas. From XPS analysis it was detected oxygen and nitrogen contamination in all the samples. It was also found that sp 3/sp 2 ratio depends on the proportion of argon in the plasma. At lower argon concentrations, hardness, wear and oxidation resistances were all improved with respect to the uncoated PVC. In such conditions, the surface wettability is low indicating a moderate receptivity to water. This combination of properties, ascribed to a balance between the ion bombardment and deposition processes, is suitable for materials exposed to rigorous weathering conditions.

Interaction of plasma proteins with commercial protein repellent polyvinyl chloride (PVC): a word of caution

Protein adsorption onto polymers remains a problem. In recent years, several protein-repellent PVC tubings have been developed. Although several studies report the interaction between plasma coagulation proteins and PVC, few address the interaction with other plasma proteins. Two commercial brands of untreated medical grade PVC tubing, phosphorylcholine-coated PVC tubing, triblock-copolymer (polycaprolactone-polydimethylsiloxane-polycaprolactone)-treated PVC tubing and poly-2-methoxyethylacrylate (PMEA)-coated tubing were exposed for 60 minutes to human plasma. A broad spectrum of plasma proteins was found on all tubing. The adsorbed albumin to total protein ratio is lower than the similar ratio in plasma while alpha1 and alpha2 globulins are over-represented in the protein spectrum. On PMEA tubing, not only alpha globulins, but also beta and gamma globulins, are found in high concentrations in the adsorbed protein. PMEA tubing and uncoated PVC tubing of brand B had a higher amount of protein adsorbed compared against all other tubing (p < 0.05). There were no statistical differences in protein adsorption between the triblock-copolymer-treated tubing, the phosphorylcholine-coated tubing and the uncoated PVC tubing of brand A. The average thickness of the protein layer was 23 nm. Plasma protein adsorption still exists on uncoated and protein-repellent tubing and can initiate a systemic inflammatory reaction.

Presence of Plasticizer Di-2(ethylhexyl)phthalate in Primed Extracorporeal Circulation Circuits

Many centers advocate the use of a standby wet-primed extracorporeal membrane oxygenation (ECMO) circuit for rapid deployment during cardiopulmonary resuscitation. However, concerns with regard to the potential health hazards associated with the release of the plasticizer di-2(ethylhexyl)phthalate (DEHP) from the polyvinyl chloride (PVC) tubing exist. The purpose of this study was to determine the time course of DEHP release from a preprimed ECMO circuit and to evaluate the effect of PVC tubing coatings on DEHP release. Seven circuits including three uncoated (Medtronic, Medtronic with albumin, and Medtronic Super Tygon) and four attenuated surfaces (Carmeda, COBE Smart, Medtronic Trillium, and Terumo x-coated) were primed with Plasmalyte A. Samples of the circuit prime were collected over a period of 2 weeks and were analyzed for DEHP, using gas chromatography. Results were compared by using a two-tailed t test. One coated (Carmeda) and all three uncoated circuits leached DEHP. The greatest amount of leaching occurred in the uncoated Medtronic tubing with albumin. The COBE Smart, Medtronic Trillium, and Terumo x-coated circuits had undetectable amounts of DEHP (p = 0.006 vs Medtronic uncoated). Prepriming an ECMO circuit composed of uncoated PVC tubing is associated with DEHP release. Using coated PVC tubing appears to eliminate DEHP release over a 2-week period.

PRESENCE OF PLASTICIZER DI-2(ETHYLHEXYL)PHTHALATE IN PRIMED EXTRACORPOREAL CIRCULATION CIRCUITS

BACKGROUND: Many centers advocate the use of a standby wet-primed extracorporeal membrane oxygenation (ECMO) circuit for rapid deployment. Concerns with regard to the potential health hazards associated with the release of the plasticizer di-2(ethylhexyl)phthalate (DEHP) from the polyvinyl chloride (PVC) tubing exist. The purpose of this study is to determine the time course of DEHP release from a pre-primed ECMO circuit, and to evaluate the effect of PVC tubing coatings on DEHP release. METHODS: Seven test circuits including 3 uncoated (Medtronic, Medtronic with albumin, or Medtronic Super Tygon) and 4 coated (Carmeda, COBE Smart, Medtronic Trillium, or Terumo X-coated) were primed with Plasmalyte. Samples of the circuit prime were collected over a period of two weeks and were analyzed for DEHP utilizing gas chromatography. RESULTS: One coated (Carmeda) and all 3 uncoated circuits leached DEHP (Figure 1). The COBE Smart, Medtronic Trillium, and Terumo X-coated circuits had undetectable amounts of DEHP (p=0.006 vs Medtronic uncoated).FigureCONCLUSIONS: Pre-priming an ECMO circuit composed of uncoated PVC tubing is associated with DEHP release. Utilizing coated PVC tubing appears to eliminate DEHP release.

Anticoagulant-free Genius® haemodialysis using low molecular weight heparin-coated circuits

Regional citrate anticoagulation or saline flushes are often used in haemodialysis patients at high risk of bleeding. In an alternative approach we evaluated the effects of covalent circuit coating with low molecular weight heparin (LMWH) for intermittent haemodialysis. In vitro, we compared the thrombogenicity of an uncoated polyvinylchloride (PVC) tubing set with LMWH-coated tubing (AOThel) and a reference tubing with end-point attached heparin coating (Carmeda Bioactive surface) under dynamic blood contact. In vivo, five chronic haemodialysis patients were studied using the Genius dialysis system and F60S filters. Each patient underwent three dialysis sessions separated by a standard haemodialysis each: (1) standard dialysis (uncoated circuit and regular dalteparin dosage), (2) dialysis with LMWH-coated circuit and regular dalteparin dosage and (3) dialysis with a completely LMWH-coated circuit without anticoagulant use. In vitro, both coated tubings showed significantly reduced thrombin-antithrombin (TAT) complex levels compared with PVC. The reference coating (Carmeda) released substantial antifactor Xa (antiXa) activity into the plasma. The LMWH coating (AOThel) released low antiXa activity only during the initial rinsing. In vivo, all dialysis sessions were well tolerated and completed without major clotting. Antithrombin levels and platelet counts were similar in all groups. P-selectin and D-dimer levels increased similarly in all groups. TAT levels were comparable in all groups during the first 3 h and significantly increased in the anticoagulant-free group after the fourth hour. LMWH surface coating reduces thrombogenicity in vitro without releasing significant amounts of heparin from the surface. In vivo, anticoagulant-free haemodialysis using a completely LMWH-coated circuit is feasible and safe in stable chronic dialysis patients with normal coagulation.

Intermittent Catheterisation with Hydrophilic-Coated Catheters (SpeediCath) Reduces the Risk of Clinical Urinary Tract Infection in Spinal Cord Injured Patients: A Prospective Randomised Parallel Comparative Trial

ObjectivesTo compare the performance of SpeediCath hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters, in traumatic spinal cord injured patients presenting with functional neurogenic bladder-sphincter disorders. MethodsA 1-year, prospective, open, parallel, comparative, randomised, multi centre study included 123 male patients, ≥16 y and injured within the last 6 months. Primary endpoints were occurrence of symptomatic urinary tract infection (UTI) and hematuria. Secondary endpoints were development of urethral strictures and convenience of use. The main hypothesis was that coated catheters cause fewer complications in terms of symptomatic UTIs and hematuria. Results57 out of 123 patients completed the 12-month study. Fewer patients using the SpeediCath hydrophilic-coated catheter (64%) experienced 1 or more UTIs compared to the uncoated PVC catheter group (82%) (p=0.02). Thus, twice as many patients in the SpeediCath group were free of UTI. There was no significant difference in the number of patients experiencing bleeding episodes (38/55 SpeediCath; 32/59 PVC) and no overall difference in the occurrence of hematuria, leukocyturia and bacteriuria. ConclusionsThe results indicate that there is a beneficial effect regarding UTI when using hydrophilic-coated catheters.

Characterisation and evaluation of novel surfactant bacterial anti-adherent coatings for endotracheal tubes designed for the prevention of ventilator-associated pneumonia.

It is accepted that ventilator-associated pneumonia is a frequent cause of morbidity and mortality in intensive care patients. This study describes the physicochemical properties of novel surfactant coatings of the endotracheal tube and the resistance to microbial adherence of surfactant coated endotracheal tube polyvinylchloride (PVC). Organic solutions of surfactants containing a range of ratios of cholesterol and lecithin (0:100, 25:75, 50:50, 75:25, dissolved in dichloromethane) were prepared and coated onto endotracheal tube PVC using a multiple dip-coating process. Using modulated temperature differential scanning calorimetry it was confirmed that the binary surfactant systems existed as physical mixtures. The surface properties of both surfactant-coated and uncoated PVC, following treatment with either pooled human saliva or phosphate-buffered saline (PBS), were characterised using dynamic contact angle analysis. Following treatment with saliva, the contact angles of PVC decreased; however, those of the coated biomaterials were unaffected, indicating different rates and extents of macromolecular adsorption from saliva onto the coated and uncoated PVC. The advancing and receding contact angles of the surfactant-coated PVC were unaffected by sonication, thereby providing evidence of the durability of the coatings. The cell surface hydrophobicity and zeta potentials of isolates of Staphylococcus aureus and Pseudomonas aeruginosa, following treatment with either saliva or PBS, and their adherence to uncoated and surfactant-coated PVC (that had been pre-treated with saliva) were examined. Adherence of S. aureus and Ps. aeruginosa to surfactant-coated PVC at each successive time period (0.5, 1, 2, 4, 8 h) was significantly lower than to uncoated PVC, the extent of the reduction frequently exceeding 90%. Interestingly, the microbial anti-adherent properties of the coatings were dependent on the lecithin content. Based on the impressive microbial anti-adherence properties and durability of the surfactant coating on PVC following dip coatings, it is proposed that these systems may usefully reduce the incidence of ventilator-associated pneumonia when employed as luminal coatings of the endotracheal tube.

Quantification of Hydrophobicity of Heparin-Treated Polyvinylchloride Tubing

It is understood that the biocompatibility of a material depends upon the proteins that bind to its surface. It is this protein layer that interacts directly with components of the coagulation and inflammatory systems. Fibrinogen, capable of platelet binding and activation, is a particularly important protein in determining a material’s biocompatibility. Hydrophobic materials tend to have a greater affinity for fibrinogen, making them less biocompatible than hydrophilic materials. We compared the hydrophobicity of three different heparin-coated polyvinylchloride (PVC) tubing preparations with uncoated PVC tubing. We also determined if there would be a difference in the applied solution; water, an ionic solution (saline), and a protein solution (fresh frozen plasma). Hydrophobicity was quantified with five separate measurements of contact angles of water, saline, and plasma, and droplet spread diameter of water and saline. We found that Duraflo II displayed hydrophobicity similar to that of uncoated PVC tubing (initial contact angles of water were 78.0 ± 1.1 and 79.6 ± 0.6 degrees, respectively). Carmeda and 3M heparin-coated tubings displayed significantly (p &lt; .01) less hydrophobicity (initial contact angles of water were 59.8 ± 2.1 and 39.6 ± 1.9, respectively). Three minutes after initial contact, the 3M heparin coating was the only preparation that remained significantly (p &lt; .01) less hydrophobic than the uncoated PVC. These data suggest that 3M heparin-coated PVC is the most biocompatible of the tubings we examined, followed by Carmeda, Duraflo II, and the untreated PVC tubing.

The use of fibronectin-coated polyvinyl chloride microtest plates to detect monoclonal antibody-binding to adherent tumor cells

This report describes the use of fibronectin-coated polyvinyl chloride (PVC) plates as a time-saving modification in an assay measuring antibody-binding to live adherent tumor cells. Three cell lines (A-431, Colo 16 and UCLA-SO-P3) derived from human squamous cell carcinomas (SCC) and forming monolayers in cultures were plated onto flexible PVC microtest plates rather than the commonly used rigid polystyrene plates. In PVC plates, two of the three cell lines (A-431 and Colo 16) grew as foci of clumped cells instead of monolayers. Coating of the plates with plasma fibronectin restored the monolayer morphology. [ 125I] Staphylococcal protein A radioimmunoassays measuring the binding of a monoclonal anti-β 2 microglobulin antibody to the cells were slightly, but consistently, more sensitive in coated PVC plates than in polystyrene plates. In contrast, the sensitivity of the radioimmunoassay was remarkably constant when the assay was performed on the third cell line (UCLA-SO-P3), which formed monolayers in any of the conditions tested. Preliminary experiments suggested that the inability to form monolayers on uncoated PVC plates correlates with the amount of fibronectin associated with the cell surface.