Neurological and general outcome in low-risk coronary artery bypass patients using heparin coated circuits

Objective: The clinical significance of heparin coating in cardiopulmonary bypass has previously been investigated. However, few studies have addresse d the possible influence on brain function and memory disturbances. Methods : Three hundred low-risk patients exposed to coronary bypass surgery were r andomised into three groups according to type of heparin coating: Carmeda B ioactive Surface, Baxter Duraflo II and a control group. Outcome was determ ined from a number of clinically oriented parameters, including a detailed registry of postoperative deviations from the normal postoperative course. Brain damage was assessed through S100 release and memory tests, including a questionnaire follow-up. Results: Clinical outcome was similar for all gr oups. Blood loss (Duraflo only), transfusion requirements and postoperative creatinine elevation were reduced in the hepar in-coated groups. A lower i ncidence of atrial fibrillation was noted in the Duraflo group. Heparin coa ting did not uniformly attenuate the release of S100 or the degree of memor y impairment. Conclusions: Cardiopulmonary bypass (CPB) with heparin coatin g and a reduced dose of heparin seems to be safe. Clinical outcome and neur ological injury seem not to be associated with type of heparin coating used for CPB. However, blood loss and transfusion requirements may be reduced. (C) 2001 Elsevier Science B.V. All rights reserved.