Clinical evaluation of Duraflo® II heparin treated extracorporeal circulation circuits (2nd version) The European working group on heparin coated extracorporeal circulation circuits

Wildevuur, Ch. R. H.; Jansen, Piet; Bezemer, P.D.; Kuik, Dirk J.; Eijsman, L.; Bruins, Peter; Jong, A. P. De; Hardevelt, F. W. J. Van; Biervliet, J. D.; Hasenkam, J. Michael; Kure, H. H.; Knudsen, Lone; Bellaiche, L.; Ahlburg, P.; Loisance, D; Baufreton, Christophe; Besnerais, P. Le; Bajan, G.; Matta, Amine; Dyck, Michel Van; Renotte, M. Th; Ponlot-Lois, A.; Baele, Ph.; McGovern, Eillish; McCarthy, John J.; A, McCarthy; O’Donnell, Aonghus; Fosse, Erik; Moen, Oddvar; Dregelid, Einar; Brockmeier, Vibeke; Anderson, Carryn M.; Pomar, José L.; Ranucci, Marco; Conti, Daniela; Cirri, Silvia; Conti, Eleonora; Ditta, Antonio; Segesser, Ludwig K. von; Tkebuchava, Tengis; Weiss, Branko M.; Turina, Marko; Svennevig, Jan; Mohr, B.; Videm, Vibeke; Karlsen, Hege; Pedersen, Tore; Thelin, Stefan; Haldén, E.; Hagman, Leif; Thorno, E.; Ahlvin, E.

doi:10.1016/s1010-7940(96)01122-0

Cited by 52 publications

(23 citation statements)

References 24 publications

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“…Our results concerning postoperative bleeding are indirectly supported by comparative studies where patients treated with noncoated circuits serve as a control group. Reduced bleeding and transfusion requirements have repeatedly been reported where a lower dose of heparin is given, 5‐8 whereas no significant effects on bleeding have been demonstrated in larger studies including full heparin dose 12‐14 . In the present study, we were not able to demonstrate any reduction in allogeneic transfusions.…”

Section: Discussioncontrasting

confidence: 66%

Heparin-Coated Circuits (Duraflo II) With Reduced Versus Full Anticoagulation During Coronary Artery Bypass Surgery

Øvrum¹,

Tangen²,

Øystese³

et al. 2003

Journal of Cardiac Surgery

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Section: Discussioncontrasting

confidence: 66%

Heparin-Coated Circuits (Duraflo II) With Reduced Versus Full Anticoagulation During Coronary Artery Bypass Surgery

Øvrum¹,

Tangen²,

Øystese³

et al. 2003

Journal of Cardiac Surgery

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“…Indeed, a clinical study showed a decreased intrapulmonary shunt with improved respiratory index (PO 2 /FiO 2 ) after CPB by using heparin-coated circuits, although intubation time and ICU stay were not affected [35]. Others, using a scoring-system based either on intubation time, the central-peripheral temperature difference, the postoperative fluid balance, and on various adverse effects after CABG, showed a significantly positive clinical effect in patients treated with heparin-coated circuits, and especially in patients with cross-clamp times exceeding 60 min [16,36]. De Vroege et al [31] demonstrated comparatively significant postoperative differences in favour of the patients treated with heparin-coated circuits in terms of the pulmonary shunt fraction, the pulmonary vascular resistance index, and the PaO 2 /FiO 2 ratio, as well as various inflammatory markers reflecting complementary activation.…”

Section: Methodology and Strategy For Management Of Lung Dysfunction mentioning

confidence: 99%

Strategies to prevent intraoperative lung injury during cardiopulmonary bypass

Apostolakis

Koletsis

Baikoussis

et al. 2010

J Cardiothorac Surg

130

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During open heart surgery the influence of a series of factors such as cardiopulmonary bypass (CPB), hypothermia, operation and anaesthesia, as well as medication and transfusion can cause a diffuse trauma in the lungs. This injury leads mostly to a postoperative interstitial pulmonary oedema and abnormal gas exchange. Substantial improvements in all of the above mentioned factors may lead to a better lung function postoperatively. By avoiding CPB, reducing its time, or by minimizing the extracorporeal surface area with the use of miniaturized circuits of CPB, beneficial effects on lung function are reported. In addition, replacement of circuit surface with biocompatible surfaces like heparin-coated, and material-independent sources of blood activation, a better postoperative lung function is observed. Meticulous myocardial protection by using hypothermia and cardioplegia methods during ischemia and reperfusion remain one of the cornerstones of postoperative lung function. The partial restoration of pulmonary artery perfusion during CPB possibly contributes to prevent pulmonary ischemia and lung dysfunction. Using medication such as corticosteroids and aprotinin, which protect the lungs during CPB, and leukocyte depletion filters for operations expected to exceed 90 minutes in CPB-time appear to be protective against the toxic impact of CPB in the lungs. The newer methods of ultrafiltration used to scavenge pro-inflammatory factors seem to be protective for the lung function. In a similar way, reducing the use of cardiotomy suction device, as well as the contact-time between free blood and pericardium, it is expected that the postoperative lung function will be improved.

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“…The European Working Group on heparin-coated circuits failed to show any clinical benefit in a multicenter randomized controlled trial of heparin-coated circuits (Duraflo II) versus standard circuits with identical heparin in lowrisk patients [50]. However, a separate multicenter randomized controlled trial in a group of high-risk patients demonstrated decreased ICU and hospital lengths of stay, as well as decreased incidence of postoperative lung and kidney dysfunction in patients undergoing CPB with the Duraflo II circuit as compared with a noncoated circuit, both with standard heparin doses [51].…”

Section: Clinical Results With Heparin-coated Circuits In Cardiopulmomentioning

confidence: 99%

Currently available biomaterials for use in cardiopulmonary bypass

Belway¹,

Rubens²

2006

Expert Review of Medical Devices

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Cardiopulmonary bypass (CPB) represents one of the most important technical innovations in healthcare history, yet the systemic responses to CPB remain a fundamentally unresolved problem. Study of the blood-biomaterial interaction and development of biocompatible materials is intimately related to efforts to optimize patient outcome following CPB. This article reviews the design innovations in biomaterial surfaces that have been introduced into clinical practice in an attempt to ameliorate the detrimental consequences of CPB, contrasting the actual clinical improvements and patient benefits achieved against those predicted on the basis of theory and in vitro testing. Some discussion of the underlying mechanisms of action as presently understood is provided and the current limitations of biomaterial-dependent strategies to improve outcome following CPB are addressed.

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Clinical evaluation of Duraflo® II heparin treated extracorporeal circulation circuits (2nd version) The European working group on heparin coated extracorporeal circulation circuits

Cited by 52 publications

References 24 publications

Heparin-Coated Circuits (Duraflo II) With Reduced Versus Full Anticoagulation During Coronary Artery Bypass Surgery

Heparin-Coated Circuits (Duraflo II) With Reduced Versus Full Anticoagulation During Coronary Artery Bypass Surgery

Strategies to prevent intraoperative lung injury during cardiopulmonary bypass

Currently available biomaterials for use in cardiopulmonary bypass

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