| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 1999;15:353-358
© 1999 Elsevier Science NL
University of Ottawa Heart Institute, Ottawa, Ontario, Canada
Received 29 September 1998; received in revised form 21 December 1998; accepted 8 January 1999.
Corresponding author. Tel.: +1-613-761-4720; fax: +1-613-761-4338; e-mail: frubens@heartinst.on.ca
Objective: Blood contact with synthetic surfaces during cardiopulmonary bypass (CPB), inevitably results in the activation of a variety of interrelated pathways of inflammation and coagulation that may contribute to postoperative complications in cardiac surgery patients. The objective of this trial was to evaluate clinical events and complement activation related to the use of a novel biomaterial, into which a surface modifying additive had been incorporated into the polymer used to prepare the bypass circuit. Methods: A prospective, double-blind trial was carried out with 34 patients randomized to surgery, with either a standard circuit or a circuit treated (`tip to tip') with the surface modifying additive. Variables recorded included perioperative haemodynamics, volume replacement, 
-agonist and inotrope use. Terminal complement complex (SC5b-9) was measured using an ELISA. Results: Upon initiation of bypass, there was a decrease in mean arterial pressure (MAP) in the control group, not seen in the test group (P=0.0005, ANOVA). There was a decrease in the total volume of replacement fluid given intraoperatively in the test group as compared with the control group (total plus prime; control 5.3±1.2 L, test 4.4±1.9 L, P=0.03, Mann–Whitney test). There was a trend to decreased need for inotrope infusion in the test group after CPB (test 1/17, control 6/17, Fisher exact test; P=0.085). No difference was seen in the generation of terminal complement complex between the groups either during or after CPB. Conclusions: The decrease in blood pressure in the control group, upon the initiation of CPB, did not occur in patients undergoing CPB with the circuit prepared with the surface modifying additive. The decrease in blood pressure was likely associated with the increase in total administered fluids intraoperatively (approximately 1 l/patient) and perhaps the trend towards higher use of inotropes in the control patients as opposed to the test patients. These haemodynamic changes did not appear to be related to complement activation early in CPB.
Key Words: Cardiopulmonary bypass • Complement activation • Blood pressure response • Biocompatibility
This article has been cited by other articles:
|
|
 |
|
  P. M. Kirshbom, B. E. Miller, K. Spitzer, K. A. Easley, C. E. Spainhour, B. E. Kogon, and K. R. Kanter Failure of surface-modified bypass circuits to improve platelet function during pediatric cardiac surgery. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 675 - 680. [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]
|
|
|
|
 |
|
 S. Allen, W. T McBride, I. S Young, S. W MacGowan, T. J McMurray, S. Prabhu, S P. Penugonda, and M. A Armstrong A clinical, renal and immunological assessment of Surface Modifying Additive Treated (SMARTTM) cardiopulmonary bypass circuits Perfusion, September 1, 2005; 20(5): 255 - 262. [Abstract] [PDF]
|
|
|
|
 |
|
 F. D. Rubens, H. Nathan, R. Labow, K. S. Williams, D. Wozny, J. Karsh, M. Ruel, and T. Mesana Effects of Methylprednisolone and a Biocompatible Copolymer Circuit on Blood Activation During Cardiopulmonary Bypass Ann. Thorac. Surg., February 1, 2005; 79(2): 655 - 665. [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 |
