| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
European Journal of Cardio-Thoracic Surgery, Vol 11, 320-327, Copyright © 1997 by European Association for Cardio-thoracic Surgery
E Fosse, S Thelin, JL Svennevig, P Jansen, TE Mollnes, E Hack, P Venge, O Moen, V Brockmeier, E Dregelid, E Halden, L Hagman, V Videm, T Pedersen and B Mohr
OBJECTIVE: This study was carried out to: (a) compare complement and
granulocyte activation during cardiac operations in patients operated with
cardiopulmonary bypass coated with heparin by the Duraflo II method, with
activation in patients operated with uncoated circuits; and (b) relate
complement, and granulocyte activation to selected adverse effects.
METHODS: In a multicentre study among Rikshospitalet, Ullevaal Hospital in
Norway and Uppsala University Hospital in Sweden, plasma concentrations of
the complement activation products C4b/iC4b/C4c (C4bc), C3b/iC3b/C3c
(C3bc), the terminal SC5b-9 complement complex (TCC), and the granulocyte
proteins myeloperoxidase and lactoferrin were assessed in two groups of
patients undergoing aortocoronary bypass. Seventy-six patients underwent
surgery operated with circuits coated by the Duraflo II heparin coating and
75 uncoated circuits. The same amount of systemic heparin was administered
to all patients. RESULTS: In both groups a significant increase in C4bc was
first seen by the end of operation, from 86.7 +/- 12.5 to 273.0 +/- 277.4
nM in controls and from 86.9 +/- 18.5 to 320.2 +/- 190.5 nM in the control
group, confirming previous documentation that the classical pathway is not
activated during CPB, but as a consequence of protamin administration. The
formation of C4bc did not differ significantly between the two groups. In
the uncoated group the C3bc concentration increased from 124.0 +/- 15.3 to
a maximum of 1176.1 +/- 64.7 nM (P < 0.01) and in the coated group it
increased from 129.8 +/- 16.1 to a maximum of 1019.4 +/- 54.9 nM (P <
0.01) during CPB. Summary values but not peak values differed significantly
between the groups. In the uncoated group the TCC concentration increased
from 0.52 +/- 0.03 to a maximum value of 8.09 +/- 0.57 AU/ml (P < 0.01)
while in the coated group the TCC concentration increased from a baseline
of 0.53 +/- 0.03 to a peak value of 5.2 +/- 0.24 AU/ml (P <0.01). The
difference between the peak values was statistically significant (P =
0.00002). In both groups a significant increase in myeloperoxidase and
lactoferrin release was observed by the end of operation. There was no
difference in myeloperoxidase or lactoferrin release between the two
groups. TCC levels were compared to the occurrence of perioperative
infarction, development of lung or renal failure, postoperative bleeding,
time on ventilator and days in hospital. Three patients developed
perioperative infarction; the peak levels of TCC were significantly higher
in these patients than in the 148 patients that did not develop infarction.
The reduction in TCC formation in the heparin-coated group was not
associated with differences in any of the other clinical parameters. Few
adverse effects occurred in the study. The peak values of C3bc were higher
in the patients needing inotropic support that in those who did not, the
relevance of this finding remains uncertain. CONCLUSION: It is concluded
that the Duraflo II heparin coating reduces complement activation,
particularly TCC formation, during CPB, but not the release of specific
neutrophil granule enzymes. No certain correlation was established between
complement and granulocyte activation and clinical outcome.
ARTICLES
Duraflo II coating of cardiopulmonary bypass circuits reduces complement activation, but does not affect the release of granulocyte enzymes : a European multicentre study
Department of Thoracic Surgery and Anaesthesiology, Ullevaal Hospital, Oslo, Norway.
This article has been cited by other articles:
|
|
 |
|
  J. W. Hammon Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation Card. Surg. Adult, January 1, 2008; 3(2008): 370 - 389. [Full Text]
|
|
|
|
 |
|
 O. Mangoush, S. Purkayastha, S. Haj-Yahia, J. Kinross, M. Hayward, F. Bartolozzi, A. Darzi, and T. Athanasiou Heparin-bonded circuits versus nonheparin-bonded circuits: an evaluation of their effect on clinical outcomes Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1058 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Quaniers, J. Leruth, A. Albert, R. R. Limet, and J.-O. Defraigne Comparison of inflammatory responses after off-pump and on-pump coronary surgery using surface modifying additives circuit. Ann. Thorac. Surg., May 1, 2006; 81(5): 1683 - 1690. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. G Raja and G. D Dreyfus Modulation of Systemic Inflammatory Response after Cardiac Surgery Asian Cardiovasc Thorac Ann, December 1, 2005; 13(4): 382 - 395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. N Hoel, V. Videm, S. T Baksaas, T. E Mollnes, F. Brosstad, and J. L Svennevig Comparison of a Duraflo II-coated cardiopulmonary bypass circuit and a trillium-coated oxygenator during open-heart surgery Perfusion, May 1, 2004; 19(3): 177 - 184. [Abstract] [PDF]
|
|
|
|
|
|
G. M. Palatianos, C. N. Foroulis, M. I. Vassili, G. Astras, K. Triantafillou, E. Papadakis, A. A. Lidoriki, E. Iliopoulou, and E. N. Melissari A prospective, double-blind study on the efficacy of the bioline surface-heparinized extracorporeal perfusion circuit Ann. Thorac. Surg., July 1, 2003; 76(1): 129 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Menasche and L. H. Edmunds Jr. Extracorporeal Circulation: The Inflammatory Response Card. Surg. Adult, January 1, 2003; 2(2003): 349 - 360. [Full Text]
|
|
|
|
|
|
L.-C. Hsu Heparin-coated cardiopulmonary bypass circuits: current status Perfusion, September 1, 2001; 16(5): 417 - 428. [Abstract] [PDF]
|
|
|
|
|
|
G Matheis, M Scholz, J Gerber, U Abdel-Rahman, G Wimmer-Greinecker, and A Moritz Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass reduces myocardial injury Perfusion, January 1, 2001; 16(1): 43 - 49. [Abstract] [PDF]
|
|
|
|
|
|
J.-O. Defraigne, J. Pincemail, R. Larbuisson, F. Blaffart, and R. Limet Cytokine release and neutrophil activation are not prevented by heparin-coated circuits and aprotinin administration Ann. Thorac. Surg., April 1, 2000; 69(4): 1084 - 1091. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Wendel and G. Ziemer Coating-techniques to improve the hemocompatibility of artificial devices used for extracorporeal circulation Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 342 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Videm, T. E. Mollnes, K. Bergh, E. Fosse, B. Mohr, T.-A. Hagve, A. O. Aasen, and J. L. Svennevig HEPARIN-COATED CARDIOPULMONARY BYPASS EQUIPMENT. II. MECHANISMS FOR REDUCED COMPLEMENT ACTIVATION IN VIVO J. Thorac. Cardiovasc. Surg., April 1, 1999; 117(4): 803 - 809. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
