Blood Damage and Activation in Cardiopulmonary Bypass

Wildevuur, Ch. R. H.

doi:10.1007/978-3-662-06119-0_44

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…In the clinical setting of CPB, other multifactorial sources of blood activation (biomaterial-independent) are known to be of major importance in the late inflammatory response. 2 Indeed, perfusion-related factors have been proved to participate in blood activation by promoting endotoxaemia. 17 Uncontrolled suction of shed blood 26 which is further activated in the pericardial cavity 27 contributes to blood activation, particularly at the end of CPB after aortic crossclamp release.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Immediately after the start of CPB, contact of blood with artificial surfaces of the extracorporeal circuit initiates different humoral and cellular cascades which result in haemostasis disturbances through coagulation and fibrinolytic activation, and in the whole body inflammatory response through different pathways. The complement system and the polymorphonuclear neutrophils are activated, as well as the mononuclear cells, leading to cytokine release such as tumour necrosis factor α (TNFα), interleukin-6 (IL-6), and interleukin-8 (IL-8).…”

Section: Introductionmentioning

confidence: 99%

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Inflammatory response to cardiopulmonary bypass using two different types of heparin-coated extracorporeal circuits

Baufreton

Moczar²,

Intrator³

et al. 1998

Perfusion

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Previous reports have highlighted the disparity in biocompatibility of two differently engineered heparin coatings during the cardiopulmonary bypass (CPB) procedure. The aim of this prospective study was to evaluate the impact of the difference in haemocompatibility provided by either the Duraflo II equipment or the Carmeda equipment in the terminal inflammatory response observed after coronary artery surgery. Thirty patients were randomly allocated to two groups to be operated on using either Duraflo II equipment (group I) or Carmeda equipment (group 2) for extracorporeal circulation (ECC). Initial inflammatory response was assessed by terminal complement complex activation (SC5b-9). The late inflammatory response observed in the postoperative period was assessed by measuring cytokine production (tumour factor necrosis (TNF alpha), interleukin IL-6, interleukin IL-8) and circulating concentrations of adhesion molecules (ELAM-1, ICAM-1). The release of SC5b-9 after CPB and after protamine administration was lower in group 2 than in group 1 (p = 0.0002 and p = 0.006, respectively). A significant production of cytokines was detected in both groups with peak values observed within the time range of 4-6 h after the start of CPB.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inflammatory response to cardiopulmonary bypass using two different types of heparin-coated extracorporeal circuits

Baufreton

Moczar²,

Intrator³

et al. 1998

Perfusion

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Clinical study of biocompatibility between open and closed heparin-coated cardiopulmonary bypass circuits

Tanaka

Oshiyama

Narisawa

et al. 2003

Journal of Artificial Organs

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The objective of this study was to investigate the difference between the closed circuit system and the open circuit system in clinical heparin-coated cardiopulmonary bypass (CPB) circuits with a centrifugal pump. We evaluated the coagulation, fibrinolysis, and inflammatory response in valvular heart surgery. Nineteen patients were assigned at random to a group for the closed circuit system or the open circuit system. This is the first report on the effect of a closed circuit in valvular surgery. We measured the platelet count, white blood cell count, plasma fibrinogen concentration, thrombin-antithrombin III complex, plasmin-Alpha2 plasmin inhibitor complex, D-dimer, interleukin-6, polymorphic neutrophil-elastase, and the plasma free hemoglobin. Blood samples were collected before the start of perfusion, 15 and 60 min after the start of perfusion, 60 min after the administration of protamine, and 1 day after the operation. During the perfusion, coagulation, fibrinolysis, and inflammatory responses were activated; however, no significant differences between the two groups were noted. In this clinical investigation with suction and the cell saving system, the closed circuit was not found to be superior to the open circuit with regard to biocompatibility.

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Blood Damage and Activation in Cardiopulmonary Bypass

Cited by 2 publications

References 18 publications

Inflammatory response to cardiopulmonary bypass using two different types of heparin-coated extracorporeal circuits

Inflammatory response to cardiopulmonary bypass using two different types of heparin-coated extracorporeal circuits

Clinical study of biocompatibility between open and closed heparin-coated cardiopulmonary bypass circuits

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