Clinical evaluation of Duraflo II heparin treated extracorporeal circulation circuits (2nd version). The European Working Group on heparin coated extracorporeal circulation circuits.

Details

Serval ID
serval:BIB_8A285A40C572
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical evaluation of Duraflo II heparin treated extracorporeal circulation circuits (2nd version). The European Working Group on heparin coated extracorporeal circulation circuits.
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Wildevuur C.R., Jansen P.G., Bezemer P.D., Kuik D.J., Eijsman L., Bruins P., De Jong A.P., Van Hardevelt F.W., Biervliet J.D., Hasenkam J.M., Kure H.H., Knudsen L., Bellaiche L., Ahlburg P., Loisance D.Y., Baufreton C., Le Besnerais P., Bajan G., Matta A., Van Dyck M., Renotte M.T., Ponlot-Lois A., Baele P., McGovern E.A., McCarthy J., McCarthy A., O'Donnell A., Fosse E., Moen O., Dregelid E., Brockmeier V., Pomar J.L., Ranucci M., Conti D., Cirri S., Conti E., Ditta A., Von Segesser L.K., Tkebuchava T., Weiss B.M., Turina M.I., Svennevig J.L., Mohr B., Videm V., Karlsen H., Pedersen T.H., Thelin S., Halden E., Hagman L., Thorno E., Ahlvin E.
ISSN
1010-7940
Publication state
Published
Issued date
1997
Peer-reviewed
Oui
Volume
11
Number
4
Pages
616-623; discussion 624-625
Language
english
Abstract
OBJECTIVES: To evaluate whether the application of heparin treated circuits for elective coronary artery surgery improves postoperative recovery, a European multicenter randomised clinical trial was carried out. METHODS: In 11 European heart centers, 805 low-risk patients underwent cardiopulmonary bypass (CPB) with either an untreated circuit (n = 407) or an identical but heparin treated circuit (n = 398, Duraflo II). RESULTS: Significant differences were found among participating centers with respect to patient characteristics, blood handling procedures and postoperative care. The use of heparin treated circuits revealed no overall changes in blood loss, blood use, time on ventilator, occurrence of adverse events, morbidity, mortality, and intensive care stay. These results did not change after adjustment for centers and (other) prognostic factors as analysed with logistic regression. In both groups no clinical or technical (patient or device related) side effects were reported. Because female gender and aortic cross clamp time appeared as prognostic factors in the logistic regression analysis, a subgroup analysis with these variables was performed. In a subpopulation of females (n = 99), those receiving heparin treated circuits needed less blood products, had a lower incidence of rhythm disturbances and were extubated earlier than controls. In another subgroup of patients with aortic cross clamp time exceeding 60 min (n = 197), the amount of patients requiring prolonged intensive care treatment (> 24 h) was significantly lower when they received heparin treated circuits versus controls. CONCLUSION: These findings suggest that improved recovery can be expected with heparin treated circuits in specific higher risk patient populations (e.g. females) and when prolonged aortic cross clamp time is anticipated. Further investigations are recommended to analyses the clinical benefit of heparin treated circuits in studies with patients in different well defined risk categories and under better standardised circumstances.
Keywords
Adult, Aged, Blood Loss, Surgical/physiopathology, Blood Loss, Surgical/prevention & control, Coronary Artery Bypass/mortality, Coronary Disease/mortality, Coronary Disease/surgery, Extracorporeal Circulation/instrumentation, Female, Heparin, Humans, Male, Middle Aged, Postoperative Complications/etiology, Postoperative Complications/mortality, Surface Properties, Survival Analysis, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2008 14:16
Last modification date
20/08/2019 14:49
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