Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits

Abstract A randomized controlled trial that involved 30 patients undergoing elective coronary artery bypass grafting was done to determine the effect of heparin-coated circuits and full heparinization on complement activation, neutrophil-mediated inflammatory response, and postoperative clinical recovery. Peak concentrations of terminal complement complex were 38% lower ( p = 0.004) in 15 patients treated with heparin-coated circuits (median 775 μg/L, interquartile range 600 to 996) compared with those in 15 patients treated with uncoated circuits (median 1249 μg/L, interquartile range 988 to 1443). Although no significant intergroup differences in concentrations of polymorphonuclear neutrophil elastase were found, a positive correlation (r s = 0.74, p p = 0.03), whereas its components showed no intergroup significance. We conclude that the use of heparin-coated circuits with full systemic heparinization results in improved biocompatibility, as assessed by complement activation, and leads to an improved postoperative recovery of the patient. (J THORAC CARDIOVASC SURG 1995;110: 829-34)