Impact of heparin bonding on pediatric cardiopulmonary bypass: a prospective randomized study

Abstract Background . Heparin-coated circuits reduce the inflammatory response to cardiopulmonary bypass in adult patients; however, little is known about its effects in the pediatric population. Two studies were performed to assess this technology's impact on inflammation and clinical outcomes. Methods . In a pilot study, complement and interleukins were measured in 19 patients who had either uncoated cardiopulmonary bypass circuits or heparin-bonded circuits. Subsequently, 23 additional patients were studied in a randomized fashion. Respiratory function and blood product utilization were recorded. Results . In the pilot study, heparin-bonded circuit patients had less complement 3a ( p p p = 0.02). Multiple variable analysis revealed that the following postoperative variables were increased with bypass time ( p = 0.01) and diminished with heparin-bonded circuits: interleukins ( p = 0.01), peak airway pressures ( p = 0.05), and prothrombin time ( p = 0.03). Conclusions . Heparin-bonded circuits significantly reduce cytokines and complement during cardiopulmonary bypass and lower interleukin levels postbypass; they were also associated with improved pulmonary and coagulation function. Heparin-bonded circuits ameliorate the systemic inflammatory response in pediatric patients from cardiopulmonary bypass.