Comparison of a Duraflo II-coated cardiopulmonary bypass circuit and a trillium-coated oxygenator during open-heart surgery.
BACKGROUND
Cardiopulmonary bypass (CPB) evokes a systemic inflammatory response. In attempting to improve the biocompatibility of the equipment, various methods to coat the inner surfaces of the CPB systems have been developed. The present study compares a Trillium Biopassive surface-coated Affinity oxygenator with a Duraflo II totally heparin-coated CPB system.


METHODS
Low-risk patients admitted for primary coronary artery bypass grafting or aortic valve replacement were randomized to operation using the Trillium- or the Duraflo II-coated setups. Heparin concentration, complement activation (C3bc activation products and terminal complement complex (TCC)), platelet activation (platelet numbers and beta-thromboglobulin (BTG)), leukocyte activation (leukocyte numbers and myeloperoxidase (MPO)), coagulation (thrombin/antithrombin complexes (TAT)) and fibrinolytic activity (plasmin/alpha2-antiplasmin complexes (PAP)) were measured during CPB and two hours postoperatively.


RESULTS
Platelet counts decreased during CPB, without significant intergroup differences. The median BTG concentration increased moderately in both groups and were slightly higher in the Trillium group during CPB (p < 0.05), but not postoperatively. Complement activation products (C3bc and TCC), leukocyte counts, MPO, TAT and PAP activity showed no differences between the two groups.


CONCLUSIONS
There were small differences in the inflammatory response between the two extracorporeal circulation devices compared in this study.
Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway. tom.nilsen.hoel@rikshospitalet.no
Tom N
TN
Hoel
Vibeke
V
Videm
Svein T
ST
Baksaas
Tom E
TE
Mollnes
Frank
F
Brosstad
Jan L
JL
Svennevig
D001777:Blood Coagulation; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage*; D003167:Complement Activation; D005260:Female; D005342:Fibrinolysis; D006493:Heparin / Q000008:administration & dosage / Q000097:blood; D006801:Humans; D007431:Intraoperative Complications / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D020556:Neutrophil Infiltration; D010106:Oxygenators; D015539:Platelet Activation; D031446:Trillium
D020099:Coated Materials, Biocompatible; D006493:Heparin