Clinical efficacy of heparin-bonded bypass circuits related to cytokine responses in children.
BACKGROUND
Cardiopulmonary bypass (CPB) induces numerous systemic reactions. This study examined the efficacy of heparin-bonded CPB circuits on inflammatory responses and postoperative status in children.


METHODS
Thirty-four infants undergoing elective cardiac surgery were randomly divided into two groups: a heparin-bonded CPB group (n = 17) and a non-heparin-bonded group (n = 17). Plasma levels of the inflammatory cytokines were measured before, during, and after CPB, and postoperative status was determined by examining the respiratory index, blood loss, and the post- and preoperative body weight percent ratio.


RESULTS
Significant differences in tumor necrosis factor-alpha, interleukin-6, and interleukin-8 patterns were observed during and after CPB between the two groups (p < 0.01, p < 0.01, p < 0.05, respectively). All cytokines measured were significantly lower in the heparin-bonded group just after CPB (p < 0.05). There were no differences in duration of intubation, intensive care unit or hospital stay, or postoperative blood loss, but the respiratory index 3 hours after CPB and body weight percent ratio 24 and 48 hours after CPB were significantly reduced in the bonded group (p < 0.05, p < 0.01, p < 0.05, respectively).


CONCLUSIONS
Our findings suggest that heparin bonding of the bypass circuits affects early postoperative status and reduces cytokine responses in pediatric cardiac surgery.
Ozawa
T
T
Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan. ts-ozawa@qb3.so-net.ne.jp
Yoshihara
K
K
Koyama
N
N
Watanabe
Y
Y
Shiono
N
N
Takanashi
Y
Y
D000925:Anticoagulants; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D020099:Coated Materials, Biocompatible; D016207:Cytokines / Q000097:blood*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006493:Heparin; D006801:Humans; D007223:Infant; D016209:Interleukin-8 / Q000097:blood; D010106:Oxygenators; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D016207:Cytokines; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D006493:Heparin