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  • Title: The influence of a heparin-coated oxygenator during cardiopulmonary bypass on postoperative lung oxygenation capacity in pediatric patients with congenital heart anomalies.
    Author: Watanabe H, Miyamura H, Hayashi J, Ohzeki H, Sugawara M, Takahashi Y, Eguchi S.
    Journal: J Card Surg; 1996; 11(6):396-401. PubMed ID: 9083864.
    Abstract:
    BACKGROUND: Cardiopulmonary bypass (CPB) causes an inflammatory response and remarkably depresses the oxygenation capacity of the lung in pediatric patients with pulmonary hypertension. Although a heparin-coated circuit is more biocompatible than an uncoated circuit, the beneficial effect of a heparin-coated circuit on the postoperative lung function in the pediatric patients remains unknown. METHODS: Sixty patients younger than 3-years-old undergoing heart operations for ventricular septal defect were divided into three groups: group I = children (n = 11) without pulmonary hypertension who underwent CPB with an uncoated oxygenator; group II = children (n = 32) with pulmonary hypertension who underwent CPB with an uncoated oxygenator; and group III = children (n = 17) with pulmonary hypertension who underwent CPB with a heparin-coated oxygenator. A respiratory index (RI) was used to assess the oxygenation capacity of the lung. RESULTS: RI in group II was significantly higher than in group I and intubation time in group II was significantly longer than in group I. There was a positive correlation between preoperative pulmonary-systemic blood pressure ratio and RI at 3 hours post-CPB. Three and six hours post-CPB, RI in group III was significantly lower than in group II, but there was no significant difference in RI between both groups at 12 hours post-CPB. CONCLUSIONS: Pulmonary hypertensive pediatric patients were vulnerable to postperfusion lung injury. Beneficial effects of a heparin-coated oxygenator in a CPB circuit was limited to the early hours post-CPB and the postoperative clinical course was not modified by the heparin-coating of a membrane oxygenator.
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