Ultra-slippery, nonirritating, and anti-inflammatory hyaluronic acid-based coating to mitigate intubation injury

Zhao, Baisong; Li, Yanpu; Wang, Qingning; Ren, Yue; Zheng, Zongsheng; Bai, Meng‐Han; Lv, Jia-Cheng; Li, Ka; Xu, Jia‐Zhuang; Li, Zhong‐Ming; Song, Xingrong

doi:10.1016/j.cej.2021.130911

Cited by 16 publications

(12 citation statements)

References 35 publications

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“…[56] The high water absorption capacity of mucosa-like hydrogel coating also facilitates aspiration of bronchial secretions, which is of immense clinic value in reducing the incidence rate of the above concerns. [57] Due to direct contact with the tube, serious trachea lesions are found for the pristine group, and it does not recover even 4 days after extubation. In spite of the low CoF, the BA group suffers similar lesions to the pristine group.…”

Section: Resultsmentioning

confidence: 98%

Mucosa‐Like Conformal Hydrogel Coating for Aqueous Lubrication

et al. 2022

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Mucosa is a protective and lubricating barrier in biological tissue, which has a great clinical inspiration because of its slippery, soft, and hydrophilic surface. However, mimicking mucosal traits on complex surface remains an enormous challenge. Herein, a novel approach to create mucosa‐like conformal hydrogel coating is developed. A thin conformal hydrogel layer mimicking the epithelial layer is obtained by first absorbing micelles, followed by forming covalent interlinks with the polymer substrate via interface‐initiated hydrogel polymerization. The resulting coating exhibits uniform thickness (≈15 µm), mucosa‐matched compliance (Young's modulus = 1.1 ± 0.1 kPa) and lubrication (coefficients of friction = 0.018 ± 0.003), robust interfacial bonding against peeling (peeling strength = 1218.0 ± 187.9 J m–2), as well as high water absorption capacity. It effectively resists adhesion of proteins and bacteria without compromising biocompatibility. As demonstrated by an in vivo cynomolgus monkey model and clinical trial, applications of the mucosa‐like conformal hydrogel coating on the endotracheal tube significantly reduce intubation‐related complications, such as invasive stimuli, mucosal lesions, laryngeal edema, inflammation, and postoperative pain. This work offers a promising prototype for surface decoration of biomedical devices and holds great prospects for clinical translation to enable interventional operations with minimally invasive impacts.

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Section: Resultsmentioning

confidence: 98%

Mucosa‐Like Conformal Hydrogel Coating for Aqueous Lubrication

et al. 2022

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“…52 Other studies have shown that hyaluronic acid, chloroquine, N-acetylcysteine, allicin, and water-in-oil (w/o) emulsion of Lasio in poly(d,l-lactide-co-glycolide) coated ETTs to be effective in alleviating and/or preventing the inflammation and sequelae caused by ETI. 2,[53][54][55] Although there are various other ETT coatings that are currently available, the studies surrounding these substances are more focused on ventilator-associated pneumonia, which is not a focus of this review.…”

Section: Possible Future Therapiesmentioning

confidence: 99%

“…51,52 Hyaluronic acid coating a ETT coating has shown to alleviate injury caused by ETI. 53 Allicin coating a Coating on ETTs has shown a decrease in proinflammatory cytokines and favorable mucosal healing. 54 Water-in-oil (w/o) emulsion of Lasio in poly(d,l-lactide-co-glycolide)…”

Section: Drug/coatingmentioning

confidence: 99%

The role of local inflammation in complications associated with intubation in pediatric patients: A narrative review

Amaya

Murillo

Gutiérrez

et al. 2023

Pediatric Anesthesia

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Endotracheal intubation (ETI) is indicated to protect and control the airway. As in any medical process, patients who require advanced airway management are not exempt from experiencing sequelae, especially when more manipulation is required to secure the airway, or in combination with procedures that may affect airway structures such as adenotonsillectomy. It is important to keep in mind that short-term intubation in healthy patients can result in significant tracheal inflammation at the microscopic level without creating symptoms. This finding has been demonstrated by studies such as the one done by Puyo et al. 1 which showed that adult patients intubated for 3 h during surgical procedures had a 10-fold increase in the number of polymorphonuclear cells between intubation and extubation. The innate immune system intervenes in the perioperative period since it is involved in the pathophysiological characteristics of subglottic stenosis and other endotracheal injuries secondary to ETI because the tracheal mucosa is constantly exposed to endogenous

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“…There are serious complications related to insertion of catheters, and catheter-associated infections may be life-threatening. A highly lubricated catheter surface could not only protect the mucous membranes of the organs from damage but also prevent patients from suffering acute pain during catheter insertion and removal. , Accordingly, it is particularly important to develop multifunctional coatings for surface functionalization of catheters that could both enhance lubrication and antibacterial performances.…”

Section: Introductionmentioning

confidence: 99%

“…Natural joints exhibited extremely efficient lubrication with coefficients of friction (COF) <0.01 under a wide range of contact loads. , The ultralow COF of joints resulted from the hydration lubrication mechanism of charged biomacromolecules on the cartilage surface, which can tightly bound large amounts of water molecules to form a tenacious but fluid-like hydration layer. , Inspired by joint lubrication, a variety of hydrophilic polymer coatings have been explored as promising boundary lubrication layers to reduce the interface friction of bioimplant surfaces. − Charged polymers, especially zwitterionic poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), were recognized as the most optimal materials for hydration lubrication. − Recently, Xu et al developed a low friction, nonirritating, and anti-inflammatory hyaluronic acid-based coating on the tracheal tube. The study in animal models demonstrated that the multifunctional coating could effectively relieve the complications of endotracheal intubation. , In addition, Liu et al. prepared a hybrid elastomer by grafting a hydrophilic polymer onto a near-infrared (NIR) photothermal Fe 3 O 4 nanoparticle-loaded polydimethylsiloxane substrate.…”

Section: Introductionmentioning

confidence: 99%

Mussel-Inspired Multicomponent Codeposition Strategy toward Antibacterial and Lubricating Multifunctional Coatings on Bioimplants

et al. 2022

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Bacterial infections and limited surface lubrication are the two key challenges for bioimplants in dynamic contact with tissues. However, the simultaneous lubricating and antibacterial properties of the bioimplants have rarely been investigated. In this work, we successfully developed a multifunctional coating with simultaneous antibacterial and lubricating properties for surface functionalization of bioimplant materials. The multifunctional coating was fabricated on a polyurethane (PU) substrate via polydopamine (PDA)-assisted multicomponent codeposition, containing polyethyleneimine (PEI) and trace amounts of copper (Cu) as synergistic antibacterial components and zwitterionic poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) as the lubricating component. The obtained PDA(Cu)/PEI/PMPC coating showed excellent antibacterial activity (antibacterial efficiency: ∼99%) to both Escherichia coli and Staphylococcus aureus compared with bare PU. The excellent antibacterial properties were attributed to the combined effect of anti-adhesion capability of hydrophilic PMPC and PEI and bactericidal activity of Cu in the coating. Meanwhile, the coefficient of friction of the coating was significantly decreased by ∼52% compared with bare PU owing to the high hydration feature of PMPC, suggesting the superior lubricating property. Furthermore, the PDA(Cu)/PEI/PMPC coating was highly biocompatible toward human umbilical vein endothelial cells demonstrated by in vitro cytotoxicity tests. This study not only contributes to the chemistry of PDA-assisted multicomponent codeposition but also provides a facile and practical way for rational design of multifunctional coatings for medical devices.

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Ultra-slippery, nonirritating, and anti-inflammatory hyaluronic acid-based coating to mitigate intubation injury

Cited by 16 publications

References 35 publications

Mucosa‐Like Conformal Hydrogel Coating for Aqueous Lubrication

Mucosa‐Like Conformal Hydrogel Coating for Aqueous Lubrication

The role of local inflammation in complications associated with intubation in pediatric patients: A narrative review

Mussel-Inspired Multicomponent Codeposition Strategy toward Antibacterial and Lubricating Multifunctional Coatings on Bioimplants

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