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The Annals of Thoracic Surgery, Vol 58, 472-477, Copyright © 1994 by The Society of Thoracic Surgeons
E Fosse, O Moen, E Johnson, G Semb, V Brockmeier, TE Mollnes, MK Fagerhol and P Venge
Plasma concentrations of the complement activation products C3b, iC3b, and
C3c; the terminal C5b-9 complement complex; and the granulocyte proteins
calprotectin, myeloperoxidase, and lactoferrin were assessed in two groups
of patients undergoing aortocoronary bypass procedures. In 10 patients
operated on, the bypass circuits were coated by the Carmeda Bio-Active
Surface and systemic heparinization was reduced to 1.5 mg/kg; in another
10, the systems were uncoated and the dosage of systemic heparinization was
4 mg/kg. In both groups, significant complement activation was observed
after the onset of cardiopulmonary bypass, but the maximum levels of C3b,
iC3b, and C3c and the terminal C5b-9 complement complex were significantly
lower in the heparin-coated group. In both groups, a significant increase
in calprotectin, myeloperoxidase, and lactoferrin release was observed by
the end of operation. The maximum myeloperoxidase levels were significantly
lower in the heparin-coated group than those in the uncoated group (p =
0.03). There was a correlation of borderline significance between the
formation of terminal C5b-9 complement complex and lactoferrin release, as
well as between the formation of terminal C5b-9 complement complex and
myeloperoxidase release (p = 0.05). The postoperative blood loss did not
differ significantly between the two groups. We conclude that coating by
end point-attached and functionally active heparin allows a significant
reduction in the amount of systemic heparinization, and significantly
reduces complement and granulocyte activation.
ARTICLES
Reduced complement and granulocyte activation with heparin-coated cardiopulmonary bypass
Department of Surgery, Ulleval Hospital, Oslo, Norway.
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E. Ovrum, L. Nilsson, P. Venge, J. W. Borowiec, and S. Thelin Eosinophil Granulocyte Activation and Heparin-Coated Cardiopulmonary Bypass Ann. Thorac. Surg., March 1, 1996; 61(3): 1038 - 1039. [Full Text]
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D. D. Muehrcke, P. M. McCarthy, R. W. Stewart, R. C. Foster, D. A. Ogella, J. A. Borsh, and D. M. Cosgrove III Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock Ann. Thorac. Surg., February 1, 1996; 61(2): 684 - 691. [Abstract] [Full Text]
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R. C. Gorman, N. P. Ziats, A. K. Rao, N. Gikakis, L. Sun, M. M. H. Khan, N. Stenach, S. Sapatnekar, V. Chouhan, J. H. Gorman III, et al. SURFACE-BOUND HEPARIN FAILS TO REDUCE THROMBIN FORMATION DURING CLINICAL CARDIOPULMONARY BYPASS J. Thorac. Cardiovasc. Surg., January 1, 1996; 111(1): 1 - 12. [Abstract] [Full Text]
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E. Ovrum, T. E. Mollnes, E. Fosse, E. A. Holen, G. Tangen, M.-A. L. Ringdal, and V. Videm High and Low Heparin Dose With Heparin-Coated Cardiopulmonary Bypass: Activation of Complement and Granulocytes Ann. Thorac. Surg., December 1, 1995; 60(6): 1755 - 1761. [Abstract] [Full Text]
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E. Ovrum, T. E. Mollnes, E. Fosse, E. A. Holen, G. Tangen, M. Abdelnoor, M.-A. L. Ringdal, R. Oystese, and P. Venge COMPLEMENT AND GRANULOCYTE ACTIVATION IN TWO DIFFERENT TYPES OF HEPARINIZED EXTRACORPOREAL CIRCUITS J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1623 - 1632. [Abstract] [Full Text]
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O. Moen, E. Fosse, V. Brockmeier, C. Andersson, T. E. Mollnes, K. Hogasen, and P. Venge Disparity in Blood Activation by Two Different Heparin-Coated Cardiopulmonary Bypass Systems Ann. Thorac. Surg., November 1, 1995; 60(5): 1317 - 1323. [Abstract] [Full Text]
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E. Ovrum, F. Brosstad, E. Am Holen, G. Tangen, and M. Abdelnoor Effects on Coagulation and Fibrinolysis With Reduced Versus Full Systemic Heparinization and Heparin-Coated Cardiopulmonary Bypass Circulation, November 1, 1995; 92(9): 2579 - 2584. [Abstract] [Full Text]
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P. G. M. Jansen, H. t. Velthuis, R. A. J. M. Huybregts, R. Paulus, E. R. Bulder, H. I. van der Spoel, P. D. Bezemer, E. H. Slaats, L. Eijsman, and C. R. H. Wildevuur Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 829 - 834. [Abstract] [Full Text]
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E. Ovrum, E. A. Holen, G. Tangen, F. Brosstad, M. Abdelnoor, M.-A. L. Ringdal, R. Oystese, and R. Istad Completely Heparinized Cardiopulmonary Bypass and Reduced Systemic Heparin: Clinical and Hemostatic Effects Ann. Thorac. Surg., August 1, 1995; 60(2): 365 - 371. [Abstract] [Full Text]
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