Coagulation, fibrinolysis and cell activation in patients and shed mediastinal blood during coronary artery bypass grafting using a new heparin-coated surface

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Johnell, MatildaUppsala universitet,Institutionen för medicinska vetenskaper,Clinical chemisrty, coagulation research (author)

Coagulation, fibrinolysis and cell activation in patients and shed mediastinal blood during coronary artery bypass grafting using a new heparin-coated surface

Article/chapterEnglish2002

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Elsevier BV,2002
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LIBRIS-ID:oai:DiVA.org:uu-91003
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-91003URI
https://doi.org/10.1067/mtc.2002.122551DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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OBJECTIVES: Heparin coating of the cardiopulmonary bypass circuit is shown to improve the biocompatibility of the surface. We have studied a new heparin surface, the Corline Heparin Surface, applied to a complete set of an extracorporeal device used during coronary artery bypass grafting in terms of activation of inflammation, coagulation, and fibrinolysis in patients and in shed mediastinal blood. METHODS: Sixty patients scheduled for coronary artery bypass grafting were randomized to one of 3 groups with heparin-coated devices receiving either a standard, high, or low dose of systemic heparin or to an uncoated but otherwise identical circuit receiving a standard dose of systemic heparin. Samples were drawn before, during, and after the operation from the pericardial cavity and in shed mediastinal blood. No autotransfusion of shed mediastinal blood was performed. RESULTS: The Corline Heparin Surface significantly reduced the activation of coagulation, fibrinolysis, platelets, and inflammation compared with that seen with the uncoated surface in combination with a standard dose of systemic heparin during cardiac surgery with cardiopulmonary bypass. Both a decrease and an increase of systemic heparin in combination with the coated heparin surface resulted in higher activation of these processes. A significantly higher expression of all studied parameters was found in the shed mediastinal blood compared with in systemic blood at the same time. CONCLUSIONS: The Corline Heparin Surface used in cardiopulmonary bypass proved to be more biocompatible than an uncoated surface when using a standard systemic heparin dose. The low dose of systemic heparin might not be sufficient to maintain the antithrombotic activity, and the high dose resulted in direct cell activation rather than a further anti-inflammatory and anticoagulatory effect.

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MEDICINE
MEDICIN

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Elgue, GracielaUppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,Immunology(Swepub:uu)gracelgu (author)
Larsson, RolfUppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,Immunology(Swepub:uu)rolflars (author)
Larsson, AndersClinical chemistry (author)
Thelin, StefanUppsala universitet,Institutionen för kirurgiska vetenskaper,Thoracic surgery(Swepub:uu)stthe227 (author)
Siegbahn, AgnetaUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)agsie424 (author)
Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:Journal of Thoracic and Cardiovascular Surgery: Elsevier BV124:2, s. 321-3320022-52231097-685X

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By the author/editor: Johnell, Matilda; Elgue, Graciela; Larsson, Rolf; Larsson, Anders; Thelin, Stefan; Siegbahn, Agneta

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