Effects of Methylprednisolone and a Biocompatible Copolymer Circuit on Blood Activation During Cardiopulmonary Bypass Fraser D. Rubens, MD, Howard Nathan,

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Presentation transcript:

Effects of Methylprednisolone and a Biocompatible Copolymer Circuit on Blood Activation During Cardiopulmonary Bypass Fraser D. Rubens, MD, Howard Nathan, MD, Rosalind Labow, PhD, Kathryn S. Williams, MS, Denise Wozny, BA, Jacob Karsh, MD, Marc Ruel, MD, Thierry Mesana, MD, PhD The Annals of Thoracic Surgery Volume 79, Issue 2, Pages 655-665 (February 2005) DOI: 10.1016/j.athoracsur.2004.07.044 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Elastase release related to cardiopulmonary bypass (CPB) in the four study groups. Repeated measures: SMA effect, p = 0.026; MPSS effect, p = 0.849; SMA*MPSS interactive effect, p = 0.681; time effect, p < 0.001; SMA effect over time, p = 0.251; MPSS effect over time, p = 0.437; SMA*MPSS interactive effect over time, p = 0.729. Sampling times as indicated in the methods. Levels are mean values ± standard error of the mean at each time point (n = 17). –○– = SMA-CPB; · · • · · = MPSS; –•– = SMA-CPB and MPSS; · · ○ · · = neither. (MPSS = methylprednisolone; post-hep = postheparin; pre-hep = preheparin; PP = postprotamine; SMA = surface modifying additive; XC off = cross-clamp off.) The Annals of Thoracic Surgery 2005 79, 655-665DOI: (10.1016/j.athoracsur.2004.07.044) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Cytokine release during and after cardiopulmonary bypass (CPB). (A) IL-6 release related to CPB in the four study groups. Repeated measures: SMA effect, p = 0.180; MPSS effect, p = 0.007; SMA*MPSS interactive effect, p = 0.390; time effect, p < 0.001; SMA effect over time, p = 0.733; MPSS effect over time, p < 0.001; SMA*MPSS interactive effect over time, p = 0.661. (B) IL-8 release related to CPB in the four study groups. Repeated measures: SMA effect, p = 0.730; MPSS effect, p < 0.001; SMA*MPSS interactive effect, p = 0.383; time effect, p = 0.186. Sampling times as indicated in the methods. Levels are mean values ± standard error of the mean at each time point (n = 17). –○– = SMA-CPB; · · • · · = MPSS; –•– = SMA-CPB and MPSS; · · ○ · · = neither. (IL = interleukin; MPSS = methylprednisolone; post-hep = postheparin; pre-hep = preheparin; PP = postprotamine; SMA = surface modifying additive; XC off = cross-clamp off.) The Annals of Thoracic Surgery 2005 79, 655-665DOI: (10.1016/j.athoracsur.2004.07.044) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Terminal complement complex (TCC) levels related to cardiopulmonary bypass (CPB) in the four study groups. The release of TCC was inhibited as an effect of SMA at the time of aortic cross-clamp release (t test, p = 0.047). Repeated measures: SMA effect, p = 0.042; MPSS effect, p = 0.650; SMA*MPSS interactive effect, p = 0.042; time effect, p < 0.001; SMA effect over time, p = 0.100; MPSS effect over time, p < 0.850; SMA*MPSS interactive effect over time, p = 0.089. Levels are mean values ± standard error of the mean at each time point (n = 17). –○– = SMA-CPB; · · • · · = MPSS; –•– = SMA-CPB and MPSS; · · ○ · · = neither. (MPSS = methylprednisolone; post-hep = postheparin; pre-hep = preheparin; PP = postprotamine; SMA = surface modifying additive; XC off = cross-clamp off.) The Annals of Thoracic Surgery 2005 79, 655-665DOI: (10.1016/j.athoracsur.2004.07.044) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Tissue plasminogen activator (tPA) antigen levels related to cardiopulmonary bypass (CPB) in the four study groups. Levels are mean values ± standard error of the mean in the four groups (n = 17). Repeated measures; SMA effect, p = 0.787; MPSS effect, p = 0.294; SMA*MPSS interactive effect, p = 0.263; time effect, p < 0.001; SMA effect over time, p = 0.797; MPSS effect over time, p = 0.009; SMA*MPSS interactive effect over time, p = 0.795. Sampling times as indicated in the methods. –○– = SMA-CPB; · · • · · = MPSS; –•– = SMA-CPB and MPSS; · · ○ · · = neither. (MPSS = methylprednisolone; post-hep = postheparin; pre-hep = preheparin; SMA = surface modifying additive.) The Annals of Thoracic Surgery 2005 79, 655-665DOI: (10.1016/j.athoracsur.2004.07.044) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions