PMID- 10800798
OWN - NLM
STAT- MEDLINE
DCOM- 20000519
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 69
IP  - 4
DP  - 2000 Apr
TI  - Cytokine release and neutrophil activation are not prevented by heparin-coated 
      circuits and aprotinin administration.
PG  - 1084-91
AB  - BACKGROUND: Cardiopulmonary bypass (CPB) initiates a whole-body inflammatory 
      response where complement and neutrophil activation and cytokine release play an 
      important role. This prospective trial examined the effects of both 
      heparin-coated circuits and aprotinin on the inflammatory processes during CPB, 
      with respect to cytokine release and neutrophil activation. METHODS: Two hundred 
      patients undergoing cardiac surgery were randomized in four groups of 50 patients 
      each: heparin-coated circuit with aprotinin (HCO-A) or without aprotinin (HCO) 
      administration, and uncoated circuit with aprotinin (C-A) or without aprotinin 
      administration (C). In groups receiving aprotinin, a high-dose regimen was given. 
      In all groups, high initial doses of heparin were used (3 mg/kg intravenously). 
      Tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8, and 
      myeloperoxidase and elastase levels were measured in plasma samples taken before, 
      during, and after CPB. RESULTS: In all groups, the TNF-alpha, IL-6, and IL-8 
      levels reached a maximum after protamine administration. After 24 hours, they 
      remained significantly elevated (IL-6 and IL-8) or returned to baseline values 
      (TNF-alpha). A similar pattern was observed with myeloperoxidase and elastase 
      levels. No significant intergroup differences were observed. CONCLUSIONS: CPB is 
      associated with cytokine release and neutrophil activation, which are not 
      attenuated by the use of heparin-coated circuits or by the administration of 
      aprotinin. Aprotinin and heparin-coated circuits do not show additive effects.
FAU - Defraigne, J O
AU  - Defraigne JO
AD  - Department of Cardiovascular Surgery, University Hospital of Liege, Belgium. 
      jo.defraigne@chu.ulg.ac.be
FAU - Pincemail, J
AU  - Pincemail J
FAU - Larbuisson, R
AU  - Larbuisson R
FAU - Blaffart, F
AU  - Blaffart F
FAU - Limet, R
AU  - Limet R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - 0 (Coated Materials, Biocompatible)
RN  - 0 (Cytokines)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Hemostatics)
RN  - 0 (Interleukin-6)
RN  - 0 (Interleukin-8)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9005-49-6 (Heparin)
RN  - 9087-70-1 (Aprotinin)
SB  - IM
MH  - Aprotinin/therapeutic use
MH  - *Cardiopulmonary Bypass
MH  - *Coated Materials, Biocompatible
MH  - Cytokines/*blood
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Hemostatics/therapeutic use
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Interleukin-6/blood
MH  - Interleukin-8/blood
MH  - Male
MH  - Middle Aged
MH  - *Neutrophil Activation
MH  - Tumor Necrosis Factor-alpha/analysis
EDAT- 2000/05/09 09:00
MHDA- 2000/06/08 09:00
CRDT- 2000/05/09 09:00
PHST- 2000/05/09 09:00 [pubmed]
PHST- 2000/06/08 09:00 [medline]
PHST- 2000/05/09 09:00 [entrez]
AID - S0003-4975(00)01093-6 [pii]
AID - 10.1016/s0003-4975(00)01093-6 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2000 Apr;69(4):1084-91. doi: 10.1016/s0003-4975(00)01093-6.