Neurological and general outcome in low-risk coronary artery bypass patients using heparin coated circuits.
OBJECTIVE
The clinical significance of heparin coating in cardiopulmonary bypass has previously been investigated. However, few studies have addressed the possible influence on brain function and memory disturbances.


METHODS
Three hundred low-risk patients exposed to coronary bypass surgery were randomised into three groups according to type of heparin coating: Carmeda Bioactive Surface, Baxter Duraflo II and a control group. Outcome was determined from a number of clinically oriented parameters, including a detailed registry of postoperative deviations from the normal postoperative course. Brain damage was assessed through S100 release and memory tests, including a questionnaire follow-up.


RESULTS
Clinical outcome was similar for all groups. Blood loss (Duraflo only), transfusion requirements and postoperative creatinine elevation were reduced in the heparin-coated groups. A lower incidence of atrial fibrillation was noted in the Duraflo group. Heparin coating did not uniformly attenuate the release of S100 or the degree of memory impairment.


CONCLUSIONS
Cardiopulmonary bypass (CPB) with heparin coating and a reduced dose of heparin seems to be safe. Clinical outcome and neurological injury seem not to be associated with type of heparin coating used for CPB. However, blood loss and transfusion requirements may be reduced.
Svenmarker
S
S
Department of Surgery and Perioperative Science, University of Umeå, Umeå, Sweden
Sandström
E
E
Karlsson
T
T
Häggmark
S
S
Jansson
E
E
Appelblad
M
M
Lindholm
R
R
Aberg
T
T
D000647:Amnesia / Q000209:etiology; D016063:Blood Loss, Surgical / Q000503:physiopathology; D001803:Blood Transfusion; D001925:Brain Damage, Chronic / Q000209:etiology; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D005260:Female; D006493:Heparin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D009418:S100 Proteins / Q000097:blood
D020099:Coated Materials, Biocompatible; D009418:S100 Proteins; D006493:Heparin