TY - JOUR
T1 - Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits
AU - Jansen, Piet G.M.
AU - te Velthuis, Henk
AU - Huybregts, Rien A.J.M.
AU - Paulus, Reginald
AU - Bulder, Eisso R.
AU - van der Spoel, Hans I.
AU - Bezemer, P. Dick
AU - Slaats, Ed H.
AU - Eijsman, León
AU - Wildevuur, Charles R.H.
PY - 1995/1/1
Y1 - 1995/1/1
N2 - A randomized controlled trial that involved 30 patients undergoing elective coronary artery bypass grafting was done to determine the effect of heparin-coated circuits and full heparinization on complement activation, neutrophil-mediated inflammatory response, and postoperative clinical recovery. Peak concentrations of terminal complement complex were 38% lower (p = 0.004) in 15 patients treated with heparin-coated circuits (median 775 μg/L, interquartile range 600 to 996) compared with those in 15 patients treated with uncoated circuits (median 1249 μg/L, interquartile range 988 to 1443). Although no significant intergroup differences in concentrations of polymorphonuclear neutrophil elastase were found, a positive correlation (r s = 0.74, p < 0.0007) was calculated between peak concentrations of terminal complement complex and polymorphonuclear neutrophil elastase. Differences in patient recovery were analyzed with use of a score composed of fluid balance, postoperative intubation time, and the difference between rectal temperature and skin temperature. The score was significantly lower in patients treated with heparin-coated circuits (p = 0.03), whereas its components showed no intergroup significance. We conclude that the use of heparin-coated circuits with full systemic heparinization results in improved biocompatibility, as assessed by complement activation, and leads to an improved postoperative recovery of the patient. (J THORAC CARDIOVASC SURG 1995;110: 829-34).
AB - A randomized controlled trial that involved 30 patients undergoing elective coronary artery bypass grafting was done to determine the effect of heparin-coated circuits and full heparinization on complement activation, neutrophil-mediated inflammatory response, and postoperative clinical recovery. Peak concentrations of terminal complement complex were 38% lower (p = 0.004) in 15 patients treated with heparin-coated circuits (median 775 μg/L, interquartile range 600 to 996) compared with those in 15 patients treated with uncoated circuits (median 1249 μg/L, interquartile range 988 to 1443). Although no significant intergroup differences in concentrations of polymorphonuclear neutrophil elastase were found, a positive correlation (r s = 0.74, p < 0.0007) was calculated between peak concentrations of terminal complement complex and polymorphonuclear neutrophil elastase. Differences in patient recovery were analyzed with use of a score composed of fluid balance, postoperative intubation time, and the difference between rectal temperature and skin temperature. The score was significantly lower in patients treated with heparin-coated circuits (p = 0.03), whereas its components showed no intergroup significance. We conclude that the use of heparin-coated circuits with full systemic heparinization results in improved biocompatibility, as assessed by complement activation, and leads to an improved postoperative recovery of the patient. (J THORAC CARDIOVASC SURG 1995;110: 829-34).
UR - http://www.scopus.com/inward/record.url?scp=0029099911&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S0022-5223(95)70117-6
DO - https://doi.org/10.1016/S0022-5223(95)70117-6
M3 - Article
C2 - 7564452
SN - 0022-5223
VL - 110
SP - 829
EP - 834
JO - The Journal of Thoracic and Cardiovascular Surgery
JF - The Journal of Thoracic and Cardiovascular Surgery
IS - 3
ER -