Superior biocompatibility of heparin-bonded circuits in pediatric cardiopulmonary bypass.
BACKGROUND
Heparin bonding of pediatric cardiopulmonary bypass circuits may decrease activation of blood compartments as inflammatory responses. We studied the biocompatibility of heparin-bonded circuits in infant cardiac surgery.


METHODS
Twenty-four infants undergoing elective cardiac surgery were randomly assigned to either a nonheparin-bonded control circuit (n = 12) or a fully heparin-bonded circuit (n = 12) including membrane oxygenator, reservoir, and all tubing. Blood samples were used to identify differences in complement activation and cytokine release between groups during and after cardiopulmonary bypass. The postbypass oxygenation index was also compared.


RESULTS
The C3 activation product in the heparin-bonded group was significantly lower during (p < 0.01) and just after (p < 0.05) cardiopulmonary bypass. No statistically significant difference in C4 activation products was observed. Lower interleukin-6 and tumor necrosis factor-alpha were found immediately after cardiopulmonary bypass (p < 0.05) and a higher mean postbypass oxygenation index was also seen (p < 0.05) in the heparin-bonded group.


CONCLUSIONS
We found that a heparin-bonded cardiopulmonary bypass circuit reduced inflammatory response and improved oxygenation in pediatric cardiac surgery. These results suggest that the superior biocompatibility of the bonded circuit may reduce pulmonary complications.
Ozawa
T
T
Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan.
Yoshihara
K
K
Koyama
N
N
Yamazaki
S
S
Takanashi
Y
Y
D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D003167:Complement Activation; D003181:Complement C4 / Q000032:analysis; D006330:Heart Defects, Congenital / Q000276:immunology / Q000601:surgery*; D006400:Hematocrit; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D010107:Oxygenators, Membrane
D020099:Coated Materials, Biocompatible; D003181:Complement C4; D015850:Interleukin-6; D006493:Heparin