The Effects of Heparin-Coated Circuit on the Total Amount of Heparin During Cardiopulmonary Bypass

Lee, Hyun Woo; Lee, Jae Woong; Park, Chul Hyun; Park, Kook Yang

Abstract

BACKGROUND: Heparin-coated circuit(HCC) results in significant reduction in complement activation, leukocyte activation, and cytokine release by reducing the material-dependent source(blood-material reaction). Although the clinical effects of HCC that results in decrease in postoperative bleeding and transfusion requirement was generally acknowledged, it is not entirely known what induces these effects. This study was performed to determine the effects of HCC on the activated clotting time(ACT) and the total amount of the heparin during cardiopulmonary bypass by comparing two groups(Group H(n = 16): The patients who used heparin-coated circuit, Group C(n = 19) : The patients who did not use heparin-coated circuit) . MATERIAL AND METHOD: From May 1999 to December 1999, 35 consecutive patients older than 16 years electively undergoing open heart surgery at Gachon medical school were studied. Thirty five patients were classified into a control group(group C, n = 19) and a HCC-treated group(group H, n = 16). Body weight, height, body surface area(BSA), pump time(PT), aortic cross clamping time(ACCT), and body temperature(BT) were determined. And the heparin and protamine during CPB were also measured. ACT was determined before heparin administration, at 20, 40 and 60 minutes after heparin administration, and after protamine administration. RESULT: No significant differences were noted either group in age, body weight, height, BSA, BT, the initial amount of heparin, and the total amount of protamine. Also there were no significant intergroup differences in the ACT. But The additional(11+/-30 versus 67+/-49 mg, p<0.05) and total amount of heparin(172+/-46 versus 239+/-70 mg, p>0.05) during CPB was significantly less in group H(176+/-44 versus 239+/-70 mg, p>0.05). Despite similar pump time in both groups, H group required approximately 38% less heparin than group C.
CONCLUSION
In conclusion, the use of HCC during cardiopulmonary bypass resulted in decrease in the additional and total amount of heparin in spite of similar pump time. This may be a factor that the clinical effects of HCC is exerted.