title: Heparin-coated cardiopulmonary bypass circuits reduce circulating complement factors and interleukin-6 in paediatric heart surgery.
abstract: Children are sensitive to the inflammatory side effects of cardiopulmonary bypass (CPB). Our intention was to investigate if the biocompatibility benefits of heparin-coated CPB circuits apply to children. In 20 operations, 19 children were randomized to heparin-coated (group HC, n = 10) or standard (group C, n = 10) bypass circuits. Plasma levels of acute phase reactants, interleukins, granulocytic proteins and complement factors were measured. All were significantly elevated after CPB. Levels of complement factor C3a (851 (791-959)ng/ml [median with quartiles] in group C, 497 (476-573)ng/ml in group HC, p < 0.001), Terminal Complement Complex (114 (71-130) AU/ml in group C, 35.5 (28.9-51.4) AU/ml in group HC, p < 0.001), and interleukin-6 (570 (203-743) pg/ml in group C, 168 (111-206)pg/ml in group HC, p = 0.005), were significantly reduced in group HC. Heparin-coated CPB circuits improve the biocompatibility of CPB during heart surgery in the paediatric patient population, as reflected by significantly reduced levels of circulating complement factors and interleukin-6.
authors.affiliation: Department of Cardiothoracic Surgery, Uppsala University Hospital, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Olsson
authors.forename: A
authors.initials: A
authors.lastname: Siegbahn
authors.forename: A
authors.initials: A
authors.lastname: Henze
authors.forename: B
authors.initials: B
authors.lastname: Nilsson
authors.forename: P
authors.initials: P
authors.lastname: Venge
authors.forename: P O
authors.initials: PO
authors.lastname: Joachimsson
authors.forename: S
authors.initials: S
authors.lastname: Thelin
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology; D000990:Antithrombin III / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D003176:Complement C3 / Q000037:antagonists & inhibitors / Q000378:metabolism*; D015938:Complement Membrane Attack Complex / Q000037:antagonists & inhibitors / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood; D007781:Lactoferrin / Q000097:blood; D010447:Peptide Hydrolases / Q000378:metabolism; D009195:Peroxidase / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome; D000093242:Interleukin-6 Inhibitors
chemical_list: D000925:Anticoagulants; D000990:Antithrombin III; D015415:Biomarkers; D002097:C-Reactive Protein; D020099:Coated Materials, Biocompatible; D003176:Complement C3; D015938:Complement Membrane Attack Complex; D006493:Heparin; D016753:Interleukin-10; D015850:Interleukin-6; D016209:Interleukin-8; D007781:Lactoferrin; D010447:Peptide Hydrolases; D009195:Peroxidase; D000093242:Interleukin-6 Inhibitors; C046193:antithrombin III-protease complex