Effects of Duraflo II heparin-coated cardiopulmonary bypass circuits on the coagulation system, endothelial damage, and cytokine release in patients with cardiac operation employing aprotinin and steroids

The effects of Duraflo II heparin coated cardiopulmonary bypass circuits, l ow-dose aprotinin, and steroids on the coagulation system, endothelial dama ge, and cytokine release were evaluated by comparing those treated with low -dose aprotinin and steroids. Twenty-four adult patients undergoing coronar y artery bypass grafting, aortic valve replacement, or valve repair surgery were randomly assigned to 2 groups: either heparin-coated (Duraflo group, n = 12) or noncoated equipment (noncoated group, n = 12) groups. In the Dur aflo group, the cardiopulmonary reservoir was also coated with heparin. The re were no significant differences in age at the time of operation, aortic cross-clamp time, cardiopulmonary bypass time, and rectal temperature durin g cardiopulmonary bypass. Standard systemic heparinization was performed. M ethylpredonisolone and low-dose aprotinin were given in both groups of pati ents. Serum XIIa factor, TAT, and IL-6 were-significantly higher in the con trol group than in the:Duraflo group during cardiopulmonary bypass (p < 0.0 1). Serum IL-8 was significantly higher in the control group than in the Du raflo group at 24 h after cardiopulmonary bypass (p < 0.05). No significant difference was found in serum thrombomodulin and TNF-alpha; both were with in normal during the study period. These results indicate that the use of D uraflo II heparin coated equipment and a heparin-coated cardiopulmonary res ervoir suppressed-excess coagulation and inflammatory reaction induced by c ardiopulmonary bypass.