Heparin-coated bypass circuits: effects on inflammatory response in pediatric cardiac operations.
BACKGROUND
This study was designed to investigate whether clinical signs of the inflammatory response in pediatric cardiac patients are reduced by heparin-coated cardiopulmonary bypass circuits and how this could be explained by differences in the pathophysiologic mechanisms involved.


METHODS
In a randomized, prospective study 19 patients underwent cardiopulmonary bypass either with Carmeda BioActive Surface bypass circuits (n = 9) or with identical noncoated circuits (control, n = 10). Clinical parameters were recorded during the first 48 hours after the start of operation. Blood samples for determination of terminal complement complex, soluble form of E-selectin, and beta-thromboglobulin were obtained perioperatively up to 24 hours after operation.


RESULTS
All clinical and inflammatory mediators showed a tendency in favor of the group with heparin-coated circuits. When analyzed on a point-by-point basis there were significant differences in postoperative central body temperature, soluble E-selectin levels, and beta-thromboglobulin levels (all p < 0.05).


CONCLUSIONS
These data suggest that the use of heparin-coated cardiopulmonary bypass offers clinical benefit and tends to reduce the release of inflammatory mediators.
Schreurs
H H
HH
Thoraxcentre, University Hospital Rotterdam, The Netherlands.
Wijers
M J
MJ
Gu
Y J
YJ
van Oeveren
W
W
van Domburg
R T
RT
de Boer
J H
JH
Bogers
A J
AJ
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001831:Body Temperature / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D015938:Complement Membrane Attack Complex / Q000032:analysis; D019040:E-Selectin / Q000097:blood; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D011446:Prospective Studies; D013499:Surface Properties; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D001620:beta-Thromboglobulin / Q000032:analysis
D000925:Anticoagulants; D015938:Complement Membrane Attack Complex; D019040:E-Selectin; D018836:Inflammation Mediators; D001620:beta-Thromboglobulin; D006493:Heparin