Adherence of
proteins, cells, and microorganisms to the surface of venous
catheters contributes to
catheter occlusion,
venous thrombosis, thrombotic
embolism, and
infections. These complications lengthen
hospital stays and increase patient morbidity and mortality. Current technologies for inhibiting these complications are limited in duration of efficacy and may induce adverse side effects. To prevent complications over the life span of a device without using active drugs, we modified a
catheter with the nonleaching polymeric
sulfobetaine (polySB), which coordinates water molecules to the
catheter surface. The modified surface effectively reduced
protein, mammalian cell, and microbial attachment in vitro and in vivo. Relative to commercial
catheters, polySB-modified
catheters exposed to human blood in vitro had a >98% reduction in the attachment and a significant reduction in activation of platelets, lymphocytes, monocytes, and neutrophils. Additionally, the accumulation of thrombotic material on the
catheter surface was reduced by >99% even after
catheters were exposed to serum in vitro for 60 days. In vivo, in a highly thrombogenic canine model, device- and vessel-associated
thrombus was reduced by 99%. In vitro adherence of a broad spectrum of microorganisms was reduced on both the external and the internal surfaces of polySB-modified
catheters compared to unmodified
catheters. When unmodified and polySB-modified
catheters were exposed to the same bacterial challenge and implanted into animals, 50% less
inflammation and fewer bacteria were associated with polySB-modified
catheters. This nonleaching, polySB-modified
catheter could have a major impact on reducing
thrombosis and
infection, thus improving patient health.