Biocompatibility of heparin-coated extracorporeal bypass circuits: A randomized, masked clinical trial Derek D. Muehrcke, MDa, Patrick M. McCarthy, MDa,

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Presentation transcript:

Biocompatibility of heparin-coated extracorporeal bypass circuits: A randomized, masked clinical trial Derek D. Muehrcke, MDa, Patrick M. McCarthy, MDa, Kandice Kottke-Marchant, MDb, Hiroaki Harasaki, MD, PhDc, Jean Pierre-Yared, MDd, Judith A. Borsh, RNa, David A. Ogella, CCPe, Delos M. Cosgrove, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 2, Pages 472-483 (August 1996) DOI: 10.1016/S0022-5223(96)70275-1 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Plasma TAT III levels are shown measured at four times during cardiac procedure in all 50 patients. Plasma levels increased in both groups in similar fashion after initiation of CPB, after crossclamp (X-clamp) was released, and slightly after protamine was given. There was no difference statistically between two groups. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Serum levels of β-TG release are shown from stimulated platelets at four times during cardiac procedure in all 50 patients. β-TG levels increased 30 minutes into bypass and after crossclamp (X-clamp) was released and in non-heparin-coated group continued to increase after protamine was given. No further increase was seen after protamine administration in heparin-coated group. There was no difference between two groups. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Platelet marker CD 62 expression is shown at four times during cardiac surgical procedure. CD 62 receptor expression (P-selectin) was similar between heparin-coated and non-heparin-coated groups and increased markedly 30 minutes into bypass; however, no further increases were seen. There was no difference between two groups. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 SEM photomicrographs of arterial line filters demonstrating intragroup variability. A, Marked leukocyte adherence in noncoated group. B, Minimal leukocyte adherence in noncoated group. C, Marked leukocyte adherence to filter in heparin-coated group. D, Minimal leukocyte adherence in heparin-coated group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 SEM photomicrographs of arterial line filters demonstrating intragroup variability. A, Marked leukocyte adherence in noncoated group. B, Minimal leukocyte adherence in noncoated group. C, Marked leukocyte adherence to filter in heparin-coated group. D, Minimal leukocyte adherence in heparin-coated group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 SEM photomicrographs of arterial line filters demonstrating intragroup variability. A, Marked leukocyte adherence in noncoated group. B, Minimal leukocyte adherence in noncoated group. C, Marked leukocyte adherence to filter in heparin-coated group. D, Minimal leukocyte adherence in heparin-coated group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 SEM photomicrographs of arterial line filters demonstrating intragroup variability. A, Marked leukocyte adherence in noncoated group. B, Minimal leukocyte adherence in noncoated group. C, Marked leukocyte adherence to filter in heparin-coated group. D, Minimal leukocyte adherence in heparin-coated group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 472-483DOI: (10.1016/S0022-5223(96)70275-1) Copyright © 1996 Mosby, Inc. Terms and Conditions