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The Effects of Heparin-coated Circuits on Complement Activation and Pulmonary Injury: A Clinical Study
The Effects of Heparin-coated Circuits on Complement Activation and Pulmonary Injury: A Clinical Study
N. SARIOSMANOĞLU, Ö. OTO, E. HAZAN, Ü. AÇIKEL, *M. YÜCESOY, *H. BAHAR
Dokuz Eylül Üniversitesi Tıp Fakültesi, Göğüs, Kalp ve Damar Cerrahisi Anabilim Dalı;İzmir
* Dokuz Eylül Üniversitesi Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı; İzmir
The role on complement activation of
cardiopulmonary bypass (CPB) with its side effects
on pulmonary, cardiac and renal function is well
known. The biocompatibility of these circulation
systems have been improved with heparin-coated
circuits. Heparin-coated circuits have dramatic
effects on the coagulation cascade, but their role on
complement activation has not been clearly defined.
in this clinical study the effect of the heparin-coated
circuits on complement activation is compared with
both consumption of native C3, C4 and also
formation of terminal complement complex C5b-9
(TCC). Early postoperative pulmonary function is
also determined with measurements of static lung
compliance, pulmonary vascular resistance and
arterial blood gases. With cardiopulmonary bypass
(CPB) native C3 and C4 were consumed, but the
differece was not significant between two groups
(p>0.05). Also TCC formation increased with CPB,
but there were no significant differences between
two groups at all measured intervals (p<0.05). Static
lung compiance also did not show a significant
difference between two groups. Pulmonary vascular
resistance was significantly lower in the
heparin-coated (HC) group in early postoperative
period (p=0.001). We believe that the method of
heparin binding may play a role in its diminished
effect on complement activation, but tho general
augmentation of the circuit s biocompatibility may
explain its beneficial effect on pulmonary vascular
resistance.
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