| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;69:1084-1091
© 2000 The Society of Thoracic Surgeons
a Department of Cardiovascular Surgery and Centre de Recherche du Département de Chirurgie, University Hospital of Liège, Liège, Belgium
b Department of Anesthesiology, University Hospital of Liège, Liège, Belgium
Address reprint requests to Dr Defraigne, Department of Cardiovascular Surgery, C.H.U. Liège, Domaine Universitaire du Sart-Tilman, 4000 Liège, Belgium
e-mail: jo.defraigne{at}chu.ulg.ac.be
Background. Cardiopulmonary bypass (CPB) initiates a whole-body inflammatory response where complement and neutrophil activation and cytokine release play an important role. This prospective trial examined the effects of both heparin-coated circuits and aprotinin on the inflammatory processes during CPB, with respect to cytokine release and neutrophil activation.
Methods. Two hundred patients undergoing cardiac surgery were randomized in four groups of 50 patients each: heparin-coated circuit with aprotinin (HCO-A) or without aprotinin (HCO) administration, and uncoated circuit with aprotinin (C-A) or without aprotinin administration (C). In groups receiving aprotinin, a high-dose regimen was given. In all groups, high initial doses of heparin were used (3 mg/kg intravenously). Tumor necrosis factor-
(TNF-), interleukin-6 (IL-6) and IL-8, and myeloperoxidase and elastase levels were measured in plasma samples taken before, during, and after CPB.
Results. In all groups, the TNF-, IL-6, and IL-8 levels reached a maximum after protamine administration. After 24 hours, they remained significantly elevated (IL-6 and IL-8) or returned to baseline values (TNF-). A similar pattern was observed with myeloperoxidase and elastase levels. No significant intergroup differences were observed.
Conclusions. CPB is associated with cytokine release and neutrophil activation, which are not attenuated by the use of heparin-coated circuits or by the administration of aprotinin. Aprotinin and heparin-coated circuits do not show additive effects.
This article has been cited by other articles:
|
|
 |
|
  M. Buerke, D. Pruefer, D. Sankat, J. M. Carter, U. Buerke, M. Russ, A. Schlitt, I. Friedrich, J. Borgermann, C. F. Vahl, et al. Effects of Aprotinin on Gene Expression and Protein Synthesis After Ischemia and Reperfusion in Rats Circulation, September 11, 2007; 116(11_suppl): I-121 - I-126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Brown, N. J.O. Birkmeyer, and G. T. O'Connor Meta-Analysis Comparing the Effectiveness and Adverse Outcomes of Antifibrinolytic Agents in Cardiac Surgery Circulation, June 5, 2007; 115(22): 2801 - 2813. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Mangoush, S. Purkayastha, S. Haj-Yahia, J. Kinross, M. Hayward, F. Bartolozzi, A. Darzi, and T. Athanasiou Heparin-bonded circuits versus nonheparin-bonded circuits: an evaluation of their effect on clinical outcomes Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1058 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. M. Bical, Y. Fromes, D. Gaillard, M. Fischer, O. Ponzio, P. Deleuze, M.-F. Gerhardt, and F. Trivin Comparison of the inflammatory response between miniaturized and standard CPB circuits in aortic valve surgery. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 699 - 702. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. D. Rubens, H. Nathan, R. Labow, K. S. Williams, D. Wozny, J. Karsh, M. Ruel, and T. Mesana Effects of Methylprednisolone and a Biocompatible Copolymer Circuit on Blood Activation During Cardiopulmonary Bypass Ann. Thorac. Surg., February 1, 2005; 79(2): 655 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Boning, J. Scheewe, T. Ivers, C. Friedrich, J. Stieh, S. Freitag, and J. T. Cremer Phosphorylcholine or heparin coating for pediatric extracorporeal circulation causes similar biologic effects in neonates and infants J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1458 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Koster, S. Huebler, F. Merkle, T. Hentschel, M. Grundel, T. Krabatsch, L. Tambeur, M. Praus, H. Habazettl, W. M. Kuebler, et al. Heparin-Level-Based Anticoagulation Management During Cardiopulmonary Bypass: A Pilot Investigation on the Effects of a Half-Dose Aprotinin Protocol on Postoperative Blood Loss and Hemostatic Activation and Inflammatory Response Anesth. Analg., February 1, 2004; 98(2): 285 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Ngaage Off-pump coronary artery bypass grafting: the myth, the logic and the science Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Gourlay and P Connolly Does cardiopulmonary bypass still represent a good investment? The biomaterials perspective Perfusion, July 1, 2003; 18(4): 225 - 231. [Abstract] [PDF]
|
|
|
|
|
|
E. Jensen, S. Andreasson, A. Bengtsson, H. Berggren, R. Ekroth, L. Lindholm, and J. Ouchterlony Influence of two different perfusion systems on inflammatory response in pediatric heart surgery Ann. Thorac. Surg., March 1, 2003; 75(3): 919 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Schmartz, Y. Tabardel, J.-C. Preiser, L. Barvais, A. d'Hollander, J. Duchateau, and J.-L. Vincent Does aprotinin influence the inflammatory response to cardiopulmonary bypass in patients? J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 184 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Kubala, M. Ciz, J. Vondracek, J. Cerny, P. Nemec, P. Studenik, H. Cizova, and A. Lojek Perioperative and postoperative course of cytokines and the metabolic activity of neutrophils in human cardiac operations and heart transplantation J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1122 - 1129. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Fromes, D. Gaillard, O. Ponzio, M. Chauffert, M.-F. Gerhardt, P. Deleuze, and O. M. Bical Reduction of the inflammatory response following coronary bypass grafting with total minimal extracorporeal circulation Eur. J. Cardiothorac. Surg., October 1, 2002; 22(4): 527 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Borgermann, I. Friedrich, S. Flohe, J. Spillner, M. Majetschak, O. Kuss, A. Sablotzki, T. Feldt, J. C. Reidemeister, and F. U. Schade Tumor necrosis factor-{alpha} production in whole blood after cardiopulmonary bypass: Downregulation caused by circulating cytokine-inhibitory activities J. Thorac. Cardiovasc. Surg., September 1, 2002; 124(3): 608 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Amand, J Pincemail, F Blaffart, R Larbuisson, R Limet, and J O Defraigne Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit Perfusion, March 1, 2002; 17(2): 117 - 123. [Abstract] [PDF]
|
|
|
|
|
|
D. Paparella, T.M. Yau, and E. Young Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 232 - 244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Pearl, D. P. Nelson, S. M. Schwartz, and P. B. Manning First-stage palliation for hypoplastic left heart syndrome in the twenty-first century Ann. Thorac. Surg., January 1, 2002; 73(1): 331 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.-C. Hsu Heparin-coated cardiopulmonary bypass circuits: current status Perfusion, September 1, 2001; 16(5): 417 - 428. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
