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Influence of two di...
Influence of two different perfusion systems on inflammatory response in pediatric heart surgery.
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- Jensen, Eva (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Andréasson, Svenerik (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna,Institute of Surgical Sciences
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- Bengtsson, Anders, 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Berggren, Håkan, 1951 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Ekroth, Rolf, 1944 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Lindholm, Lena (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Ouchterlony, John (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna,Institute of Surgical Sciences
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(creator_code:org_t)
- 2003
- 2003
- English.
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In: The Annals of thoracic surgery. - 0003-4975. ; 75:3, s. 919-25
- Related links:
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Abstract
Subject headings
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- 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.
Keyword
- 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
Publication and Content Type
- ref (subject category)
- art (subject category)
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