Document Detail


Off-pump cardiac surgery abolishes complement activation.
MedLine Citation:
PMID:  18181513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This prospective randomized study compared the inflammatory response in patients undergoing elective on-pump and off-pump coronary artery bypass grafting. PATIENTS AND METHODS: Forty-four patients undergoing elective coronary artery bypass grafting were recruited with 22 patients randomized to on-pump heart surgery and 22 patients to off-pump coronary bypass surgery. Plasma levels of C3bc, the terminal SC5b-9 complement complex, myeloperoxidase, beta-thromboglobulin and prothrombin fragment F1 + 2 were measured before the operation, intraoperatively, at termination of the operation, and two hours post-operatively. RESULTS: Complement was markedly activated in the on-pump group as indicated by a significant increase in C3bc and SC5b-9 (p < 0.001 for both), whereas no complement activation was seen in the off-pump group (p = 0.001 between the groups). In contrast, both groups showed significant activation of neutrophils, platelets and coagulation, as indicated by an early increase in myeloperoxidase and a post-operative increase in beta-thromboglobulin and F1 + 2, respectively. Notably, there were no intergroup differences with regard to neutrophil and platelet activation, whereas coagulation activation was more pronounced in the off-pump group (p < 0.01). CONCLUSIONS: Off-pump surgery completely eliminated the heart-lung machine-induced complement activation. Neutrophils and platelets were equally activated in both groups, whereas coagulation was enhanced post-operatively in the off-pump group.
Authors:
Tom N Hoel; Vibeke Videm; Tom E Mollnes; Kjell Saatvedt; Frank Brosstad; Arnt E Fiane; Erik Fosse; Jan L Svennevig
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Perfusion     Volume:  22     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2008-01-09     Completed Date:  2008-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway. tom.nilsen.hoel@rikshospitalet.no
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation
Cardiopulmonary Bypass
Complement Activation*
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump*
Extracorporeal Circulation
Heart Diseases / surgery*
Heart-Lung Machine
Humans
Neutrophil Activation
Platelet Activation
Grant Support
ID/Acronym/Agency:
EB003968/EB/NIBIB NIH HHS; R01-EB-003968-01/EB/NIBIB NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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