Heparin-coated bypass circuits: Effects on inflammatory response in pediatric cardiac operations

Abstract

Background. This study was designed to investigate whether clinical signs of the inflammatory response in pediatric cardiac patients are reduced by heparin-coated cardiopulmonary bypass circuits and how this could be explained by differences in the pathophysiologic mechanisms involved. Methods. In a randomized, prospective Study 19 patients underwent cardiopulmonary bypass either with Carmeda BioActive Surface bypass circuits (n = 9) or with identical noncoated circuits (control, n = 10). Clinical parameters were recorded during the first 48 hours after the start of operation. Blood samples for determination of terminal complement complex, soluble form of E-selectin, and beta-thromboglobulin were obtained perioperatively up to 24 hours after operation. Results. All clinical and inflammatory mediators showed a tendency in favor of the group with heparin- coated circuits. When analyzed on a point-by-point basis there were significant differences in postoperative central body temperature, soluble E- selectin levels, and beta-thromboglobulin levels (all p < 0.05). Conclusions. These data suggest that the use of heparin-coated cardiopulmonary bypass offers clinical benefit and tends to reduce the release of inflammatory mediators.