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Ann Thorac Surg 2000;69:584-590
© 2000 The Society of Thoracic Surgeons

Original Articles

Clinical efficacy of heparin-bonded bypass circuits related to cytokine responses in children

Tsukasa Ozawa, MDa, Katsunori Yoshihara, MDa, Nobuya Koyama, MDa, Yoshinori Watanabe, MDa, Noritsugu Shiono, MDa, Yoshinori Takanashi, MDa

a Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan

Address reprint requests to Dr Ozawa, Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, 6-11-1, Ohmori-nishi, Ohta-ku, Tokyo, 143-8541, Japan
e-mail: ts-ozawa{at}qb3.so-net.ne.jp

Background. Cardiopulmonary bypass (CPB) induces numerous systemic reactions. This study examined the efficacy of heparin-bonded CPB circuits on inflammatory responses and postoperative status in children.

Methods. Thirty-four infants undergoing elective cardiac surgery were randomly divided into two groups: a heparin-bonded CPB group (n = 17) and a non-heparin-bonded group (n = 17). Plasma levels of the inflammatory cytokines were measured before, during, and after CPB, and postoperative status was determined by examining the respiratory index, blood loss, and the post- and preoperative body weight percent ratio.

Results. Significant differences in tumor necrosis factor-{alpha}, interleukin-6, and interleukin-8 patterns were observed during and after CPB between the two groups (p < 0.01, p < 0.01, p < 0.05, respectively). All cytokines measured were significantly lower in the heparin-bonded group just after CPB (p < 0.05). There were no differences in duration of intubation, intensive care unit or hospital stay, or postoperative blood loss, but the respiratory index 3 hours after CPB and body weight percent ratio 24 and 48 hours after CPB were significantly reduced in the bonded group (p < 0.05, p < 0.01, p < 0.05, respectively).

Conclusions. Our findings suggest that heparin bonding of the bypass circuits affects early postoperative status and reduces cytokine responses in pediatric cardiac surgery.




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