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Influence of two different perfusion systems on inflammatory response in pediatric heart surgery.

Jensen, Eva, (författare)
Göteborgs universitet, Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård, Gothenburg University, Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
Andréasson, Svenerik, (författare)
Göteborgs universitet, Institutionen för de kirurgiska disciplinerna, Gothenburg University, Institute of Surgical Sciences
Bengtsson, Anders, 1954- (författare)
Göteborgs universitet, Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård, Gothenburg University, Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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Berggren, Håkan, 1951- (författare)
Göteborgs universitet, Hjärt-kärlinstitutionen, Gothenburg University, Cardiovascular Institute
Ekroth, Rolf, 1944- (författare)
Göteborgs universitet, Hjärt-kärlinstitutionen, Gothenburg University, Cardiovascular Institute
Lindholm, Lena, (författare)
Göteborgs universitet, Hjärt-kärlinstitutionen, Gothenburg University, Cardiovascular Institute
Ouchterlony, John, (författare)
Göteborgs universitet, Institutionen för de kirurgiska disciplinerna, Gothenburg University, Institute of Surgical Sciences
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Göteborgs universitet Sahlgrenska akademin. Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård. 
Göteborgs universitet Sahlgrenska akademin. Institutionen för de kirurgiska disciplinerna. 
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Göteborgs universitet Sahlgrenska akademin. Hjärt-kärlinstitutionen. 
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2003
Engelska.
Ingår i: The Annals of thoracic surgery. - 0003-4975. ; 75:3, s. 919-25
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: This study tests the hypothesis that a cardiopulmonary bypass system that combines complete heparin-coating, a centrifugal pump, and a closed circuit in comparison with a conventional system (uncoated system, roller pump, and hard shell venous reservoir) attenuates the inflammatory response in pediatric heart surgery. METHODS: In a prospective randomized controlled clinical study 40 consecutive children weighing 10 kg or less were included and divided into two groups. Concentrations of complement proteins (C3a, sC5b-9, C4d, and Bb), granulocyte degranulation products (polymorphonuclear [PMN] elastase), and proinflammatory cytokines (tumor necrosis factor [TNF]-alpha, interleukin [IL]-6, and IL-8) were measured. RESULTS: C3a and sC5b-9 concentrations were lower (C3a, p < 0.001; sC5b-9, p = 0.01) in the combined (heparin-coated/centrifugal pump/closed reservoir) group, the peak values being 58% and 37% of conventional group values. The Bb- and C4d-fragment values indicated activation of the complement system through the alternative pathway in both groups. PMN elastase concentrations were lower (p = 0.02) in the combined group, the peak values being 43% of conventional group values. There were no significant intergroup differences regarding TNF-alpha, IL-6, or IL-8 concentrations. CONCLUSIONS: The use of a fully heparin-coated system, a centrifugal pump, and a closed circuit during CPB in children (10 kg or less) leads to a lower degree of complement activation and PMN elastase release compared with a conventional system.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  (hsv//swe)
MEDICAL AND HEALTH SCIENCES  (hsv//eng)

Nyckelord

Adolescent
Cardiopulmonary Bypass
instrumentation
Child
Child
Preschool
Coated Materials
Biocompatible
Complement Activation
immunology
Equipment Design
Female
Heart Defects
Congenital
surgery
Heparin
Humans
Infant
Inflammation Mediators
blood
Interleukin-6
blood
Interleukin-8
blood
Leukocyte Elastase
blood
Male
Postoperative Complications
immunology
prevention & control
Systemic Inflammatory Response Syndrome
immunology
prevention & control
Tumor Necrosis Factor-alpha
metabolism

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