Effects of Duraflo II Heparin-Coated Cardiopulmonary Bypass Circuits on the Coagulation System, Endothelial Damage, and Cytokine Release in Patients with Cardiac Operation Employing Aprotinin and Steroids

: The effects of Duraflo II heparin coated cardiopulmonary bypass circuits, low‐dose aprotinin, and steroids on the coagulation system, endothelial damage, and cytokine release were evaluated by comparing those treated with low‐dose aprotinin and steroids. Twenty‐four adult patients undergoing coron...

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Bibliographic Details
Published in:Artificial organs 1999-12, Vol.23 (12), p.1107-1112
Main Authors: Inui, Kiyoshige, Shimazaki, Yasuhisa, Watanabe, Takao, Takahashi, Toshiki, Minowa, Takashi, Takeda, Hirofumi, Yanagawa, Naoki, Sotoda, Yoko
Format: Article
Language:English
Subjects:
Aged
Analysis of Variance
Anti-Inflammatory Agents - pharmacology
Aprotinin - pharmacology
Blood Coagulation - drug effects
Cardiopulmonary Bypass - instrumentation
Cardiopulmonary bypass circuits
Coagulation
Coated Materials, Biocompatible - pharmacology
Cytokines - metabolism
Endothelium, Vascular - drug effects
Enzyme-Linked Immunosorbent Assay
Female
Hemostatics - pharmacology
Heparin - pharmacology
Heparin-coated circuits
Humans
Inflammation - prevention & control
Inflammatory reaction
Male
Methylprednisolone - pharmacology
Middle Aged
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Summary:: The effects of Duraflo II heparin coated cardiopulmonary bypass circuits, low‐dose aprotinin, and steroids on the coagulation system, endothelial damage, and cytokine release were evaluated by comparing those treated with low‐dose aprotinin and steroids. Twenty‐four adult patients undergoing coronary artery bypass grafting, aortic valve replacement, or valve repair surgery were randomly assigned to 2 groups: either heparin‐coated (Duraflo group, n = 12) or noncoated equipment (noncoated group, n = 12) groups. In the Duraflo group, the cardiopulmonary reservoir was also coated with heparin. There were no significant differences in age at the time of operation, aortic cross‐clamp time, cardiopulmonary bypass time, and rectal temperature during cardiopulmonary bypass. Standard systemic heparinization was performed. Methylpredonisolone and low‐dose aprotinin were given in both groups of patients. Serum XIIa factor, TAT, and IL‐6 were significantly higher in the control group than in the Duraflo group during cardiopulmonary bypass (p < 0.01). Serum IL‐8 was significantly higher in the control group than in the Duraflo group at 24 h after cardiopulmonary bypass (p < 0.05). No significant difference was found in serum thrombomodulin and TNF‐α; both were within normal during the study period. These results indicate that the use of Duraflo II heparin coated equipment and a heparin‐coated cardiopulmonary reservoir suppressed excess coagulation and inflammatory reaction induced by cardiopulmonary bypass.
ISSN:0160-564X
1525-1594
DOI:10.1111/j.1525-1594.1999.06335.x