IL-6 and IL-8 levels after cardiopulmonary bypass are not affected by surface coating.
BACKGROUND.:Contact of blood with the surfaces of the cardiopulmonary bypass (CPB) circuit has been implicated as a cause of the inflammatory response. We undertook a prospective randomized trial of 200 pediatric patients, all with a calculated total bypass flow of less than 2.3 L/min (< 0.96 L/m2/min).


METHODS
Patients were randomly assigned to 1 of 4 CPB groups: (1) Nonheparin-bonded circuit with no albumin preprime; (2) Nonheparin-bonded circuit with albumin preprime; (3) Heparin-bonded circuit with no albumin preprime; (4) Heparin-bonded circuit with albumin preprime. Measurements of cytokines, (interleukin [IL]-6, IL-8) and blood cell counts were made prebypass and 6 and 24 hours after institution of cardiopulmonary bypass.


RESULTS
Analysis of variance showed no significant difference in any of the clinical or biochemical characteristics of the 4 groups. The interaction between heparin-bonded oxygenators and albumin preprime was not significant. No important differences in IL-6 or IL-8 concentrations were noted after CPB using either heparin or nonheparin-bonded oxygenators with albumin or albumin free preprime using two-way analysis of variance.


CONCLUSIONS
Albumin preprime and heparin-bonding do not attenuate the inflammatory response component attributable to the concentration of these markers.
Horton
S B
SB
Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, Australia.
Butt
W W
WW
Mullaly
R J
RJ
Thuys
C A
CA
O'Connor
E B
EB
Byron
K
K
Cochrane
A D
AD
Brizard
C P
CP
Karl
T R
TR
D000418:Albumins; D002315:Cardiopulmonary Bypass; D002648:Child; D020099:Coated Materials, Biocompatible; D006330:Heart Defects, Congenital / Q000276:immunology / Q000601:surgery; D006493:Heparin; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D010107:Oxygenators, Membrane; D011183:Postoperative Complications / Q000276:immunology*; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology*
D000418:Albumins; D020099:Coated Materials, Biocompatible; D015850:Interleukin-6; D016209:Interleukin-8; D006493:Heparin