Comparison of a Duraflo II-coated cardiopulmonary bypass circuit and a trillium-coated oxygenator during open-heart surgery

Perfusion. 2004 May;19(3):177-84. doi: 10.1191/0267659104pf737oa.

Abstract

Background: Cardiopulmonary bypass (CPB) evokes a systemic inflammatory response. In attempting to improve the biocompatibility of the equipment, various methods to coat the inner surfaces of the CPB systems have been developed. The present study compares a Trillium Biopassive surface-coated Affinity oxygenator with a Duraflo II totally heparin-coated CPB system.

Methods: Low-risk patients admitted for primary coronary artery bypass grafting or aortic valve replacement were randomized to operation using the Trillium- or the Duraflo II-coated setups. Heparin concentration, complement activation (C3bc activation products and terminal complement complex (TCC)), platelet activation (platelet numbers and beta-thromboglobulin (BTG)), leukocyte activation (leukocyte numbers and myeloperoxidase (MPO)), coagulation (thrombin/antithrombin complexes (TAT)) and fibrinolytic activity (plasmin/alpha2-antiplasmin complexes (PAP)) were measured during CPB and two hours postoperatively.

Results: Platelet counts decreased during CPB, without significant intergroup differences. The median BTG concentration increased moderately in both groups and were slightly higher in the Trillium group during CPB (p < 0.05), but not postoperatively. Complement activation products (C3bc and TCC), leukocyte counts, MPO, TAT and PAP activity showed no differences between the two groups.

Conclusions: There were small differences in the inflammatory response between the two extracorporeal circulation devices compared in this study.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Coagulation
  • Cardiac Surgical Procedures* / instrumentation*
  • Cardiopulmonary Bypass / instrumentation*
  • Coated Materials, Biocompatible / administration & dosage*
  • Complement Activation
  • Female
  • Fibrinolysis
  • Heparin / administration & dosage
  • Heparin / blood
  • Humans
  • Intraoperative Complications / immunology
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neutrophil Infiltration
  • Oxygenators*
  • Platelet Activation
  • Trillium*

Substances

  • Coated Materials, Biocompatible
  • Heparin