title: Effects of Duraflo II heparin-coated cardiopulmonary bypass circuits on the coagulation system, endothelial damage, and cytokine release in patients with cardiac operation employing aprotinin and steroids.
abstract: The effects of Duraflo II heparin coated cardiopulmonary bypass circuits, low-dose aprotinin, and steroids on the coagulation system, endothelial damage, and cytokine release were evaluated by comparing those treated with low-dose aprotinin and steroids. Twenty-four adult patients undergoing coronary artery bypass grafting, aortic valve replacement, or valve repair surgery were randomly assigned to 2 groups: either heparin-coated (Duraflo group, n = 12) or noncoated equipment (noncoated group, n = 12) groups. In the Duraflo group, the cardiopulmonary reservoir was also coated with heparin. There were no significant differences in age at the time of operation, aortic cross-clamp time, cardiopulmonary bypass time, and rectal temperature during cardiopulmonary bypass. Standard systemic heparinization was performed. Methylpredonisolone and low-dose aprotinin were given in both groups of patients. Serum XIIa factor, TAT, and IL-6 were significantly higher in the control group than in the Duraflo group during cardiopulmonary bypass (p < 0.01). Serum IL-8 was significantly higher in the control group than in the Duraflo group at 24 h after cardiopulmonary bypass (p < 0.05). No significant difference was found in serum thrombomodulin and TNF-alpha; both were within normal during the study period. These results indicate that the use of Duraflo II heparin coated equipment and a heparin-coated cardiopulmonary reservoir suppressed excess coagulation and inflammatory reaction induced by cardiopulmonary bypass.
authors.affiliation: Second Department of Surgery, Yamagata university School of Medicine, Yamagata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Inui
authors.forename: Y
authors.initials: Y
authors.lastname: Shimazaki
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Minowa
authors.forename: H
authors.initials: H
authors.lastname: Takeda
authors.forename: N
authors.initials: N
authors.lastname: Yanagawa
authors.forename: Y
authors.initials: Y
authors.lastname: Sotoda
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D007611:Aprotinin / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000494:pharmacology*; D016207:Cytokines / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000187:drug effects*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006490:Hemostatics / Q000494:pharmacology; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D008875:Middle Aged
chemical_list: D000893:Anti-Inflammatory Agents; D020099:Coated Materials, Biocompatible; D016207:Cytokines; D006490:Hemostatics; D006493:Heparin; D007611:Aprotinin; D008775:Methylprednisolone