The impact of heparin-coated circuits on hemodynamics during and after cardiopulmonary bypass.
This study was performed to investigate if heparin-coated extracorporeal circuits can reduce the systemic inflammatory reaction with the subsequent release of vasoactive substances during and after cardiopulmonary bypass. Fifty-one patients scheduled for coronary artery bypass grafting were perfused with either a heparin-coated or an uncoated circuit. During bypass the mean arterial pressure was maintained as near as possible to 60 mm Hg. Mediators for inflammation, hemodynamic, and oxygen parameters were determined during and after bypass. To reach the target mean arterial pressure in the first hour of bypass the pump flow in the uncoated group had to be increased (P<0.05), consequently the systemic vascular resistance index decreased (P<0.05). After bypass more inotropic support was necessary in this group to reach this pressure. In the coated group less bradykinin, complement activation, and elastase was generated during bypass (P<0.05). The results of this study suggest that heparin coating not only improves biocompatibility, but also ameliorates the hemodynamic instability during and after bypass.
de Vroege
Roel
R
Department of Extracorporeal Circulation, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands. r.devroege@vumc.nl
Huybregts
Rien
R
van Oeveren
Wim
W
van Klarenbosch
Jan
J
Linley
Gerard
G
Mutlu
Jihan
J
Jansen
Evert
E
Hack
Erik
E
Eijsman
Leon
L
Wildevuur
Charles
C
D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D018709:Statistics, Nonparametric; D014655:Vascular Resistance / Q000187:drug effects
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D006493:Heparin