Impact of heparin bonding on pediatric cardiopulmonary bypass: a prospective randomized study
| Autor: | David Kim, Stephen B. Colvin, Christopher C. Derivaux, Aubrey C. Galloway, Bryan M. Steinberg, Sophie Chau, Klaus Kallenbach, Miguel G Aguinaga, Michael Artman, Eugene A. Grossi, Shilesh Iyer, Majid Tayyarah |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Surface Properties medicine.drug_class Complement C5a Pilot Projects Inflammation law.invention Coated Materials Biocompatible Fibrinolytic Agents law Blood product medicine Cardiopulmonary bypass Humans Respiratory function Prospective Studies Prothrombin time Cardiopulmonary Bypass medicine.diagnostic_test Heparin Interleukin-6 business.industry Interleukin-8 Anticoagulant Infant Child Preschool Anesthesia Complement C3a Female Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Complication Interleukin-1 medicine.drug |
| Zdroj: | The Annals of Thoracic Surgery. 70:191-196 |
| ISSN: | 0003-4975 |
| Popis: | Heparin-coated circuits reduce the inflammatory response to cardiopulmonary bypass in adult patients; however, little is known about its effects in the pediatric population. Two studies were performed to assess this technology's impact on inflammation and clinical outcomes.In a pilot study, complement and interleukins were measured in 19 patients who had either uncoated cardiopulmonary bypass circuits or heparin-bonded circuits. Subsequently, 23 additional patients were studied in a randomized fashion. Respiratory function and blood product utilization were recorded.In the pilot study, heparin-bonded circuit patients had less complement 3a (p0.001) and interleukin-8 (p0.05) compared with uncoated cardiopulmonary bypass circuit patients. The randomized study revealed that the heparin-bonded circuit was associated with reduced complement 3a (p = 0.02). Multiple variable analysis revealed that the following postoperative variables were increased with bypass time (p = 0.01) and diminished with heparin-bonded circuits: interleukins (p = 0.01), peak airway pressures (p = 0.05), and prothrombin time (p = 0.03).Heparin-bonded circuits significantly reduce cytokines and complement during cardiopulmonary bypass and lower interleukin levels postbypass; they were also associated with improved pulmonary and coagulation function. Heparin-bonded circuits ameliorate the systemic inflammatory response in pediatric patients from cardiopulmonary bypass. |
| Databáze: | OpenAIRE |
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