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

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.

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