title: The influence of a heparin-coated oxygenator during cardiopulmonary bypass on postoperative lung oxygenation capacity in pediatric patients with congenital heart anomalies.
abstract: BACKGROUND
  Cardiopulmonary bypass (CPB) causes an inflammatory response and remarkably depresses the oxygenation capacity of the lung in pediatric patients with pulmonary hypertension. Although a heparin-coated circuit is more biocompatible than an uncoated circuit, the beneficial effect of a heparin-coated circuit on the postoperative lung function in the pediatric patients remains unknown.
  
  
  METHODS
  Sixty patients younger than 3-years-old undergoing heart operations for ventricular septal defect were divided into three groups: group I = children (n = 11) without pulmonary hypertension who underwent CPB with an uncoated oxygenator; group II = children (n = 32) with pulmonary hypertension who underwent CPB with an uncoated oxygenator; and group III = children (n = 17) with pulmonary hypertension who underwent CPB with a heparin-coated oxygenator. A respiratory index (RI) was used to assess the oxygenation capacity of the lung.
  
  
  RESULTS
  RI in group II was significantly higher than in group I and intubation time in group II was significantly longer than in group I. There was a positive correlation between preoperative pulmonary-systemic blood pressure ratio and RI at 3 hours post-CPB. Three and six hours post-CPB, RI in group III was significantly lower than in group II, but there was no significant difference in RI between both groups at 12 hours post-CPB.
  
  
  CONCLUSIONS
  Pulmonary hypertensive pediatric patients were vulnerable to postperfusion lung injury. Beneficial effects of a heparin-coated oxygenator in a CPB circuit was limited to the early hours post-CPB and the postoperative clinical course was not modified by the heparin-coating of a membrane oxygenator.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
authors.forename: H
authors.initials: H
authors.lastname: Miyamura
authors.forename: J
authors.initials: J
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Ohzeki
authors.forename: M
authors.initials: M
authors.lastname: Sugawara
authors.forename: Y
authors.initials: Y
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation; D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006493:Heparin; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D007223:Infant; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010107:Oxygenators, Membrane; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D006493:Heparin