title: Increased cerebral blood flow velocities assessed by transcranial Doppler examination is associated with complement activation after cardiopulmonary bypass.
abstract: The role of complement activation on the cerebral vasculature after cardiopulmonary bypass (CPB) is unclear. The goal of the study was to assess whether heparin-coated CPB reduces complement activation, and influences cerebral blood flow velocities (CBFV). Twenty-four patients undergoing coronary surgery were randomly allocated to non-coated (NC-group) or heparin-coated (HC-group) CPB. Complement activation was assessed by measuring sC5b-9. Transcranial Doppler (TCD) was performed on middle cerebral arteries before and after CPB. Systolic (SV), diastolic (DV) and mean (MV) CBFV were measured. Significant increase of sC5b-9 (p=0.003) was observed in the NC-group and CBFV increased after CPB (SV by 27%, p=0.05; DV by 40%, p=0.06; MV by 33%, p=0.04) whereas no changes were detected in the HC-group. TCD values were higher in the NC-group than in the HC-group (SV, p=0.04; DV, p=0.03; MV, p=0.03) although cardiac index, systemic vascular resistance, haematocrit and pCO(2) were similar. Postoperative SV, DV and MV were significantly correlated with sC5b-9 (r=0.583, p=0.009; r=0.581, p=0.009; r=0.598, p=0.007, respectively). Increased CBFV after CPB are correlated to the level of complement activation and may be controlled by heparin-coated circuits.
authors.affiliation: Department of Cardiac Surgery, University Hospital, Angers, France. ChBaufreton@chu-angers.fr
authors.forename: C
authors.initials: C
authors.lastname: Baufreton
authors.forename: F
authors.initials: F
authors.lastname: Pinaud
authors.forename: J J
authors.initials: JJ
authors.lastname: Corbeau
authors.forename: A
authors.initials: A
authors.lastname: Chevailler
authors.forename: D
authors.initials: D
authors.lastname: Jolivot
authors.forename: A
authors.initials: A
authors.lastname: Ter Minassian
authors.forename: D
authors.initials: D
authors.lastname: Henrion
authors.forename: J L
authors.initials: JL
authors.lastname: de Brux
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D001921:Brain / Q000098:blood supply* / Q000276:immunology / Q000503:physiopathology*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D003167:Complement Activation / Q000187:drug effects*; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D008875:Middle Aged; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D006493:Heparin