Impact of heparin or non-heparin coated circuits on platelet function in pediatric cardiac surgery

Chiara Giorni, Chiara Pezzella, Mirela Bojan, Zaccaria Ricci, Philippe Pouard, Olivier Raisky, Laurent Tourneur, Ondina La Salvia, Isabella Favia, Delphine Borgel, Paola Cogo, Adriano Carotti, Dominique Lasne

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Abstract

BACKGROUND: Extracorporeal circuit coating has been shown to improve coagulation derangements during pediatric cardiopulmonary bypass (CPB). The aim of this study was to compare platelet function and hemostasis activation in pediatric cardiac surgery conducted with non-heparin coating (Balance®) versus heparin-based coating (Carmeda®) circuits.

METHODS: A prospective, randomized, double-center trial was conducted in children older than one month undergoing congenital heart disease (CHD) treatment. Blood samples were collected at baseline (T0), 15 minutes after the start of CPB (T1), and 15 minutes (T2) and 1 hour after the conclusion of CPB (T3). The primary endpoint of the study was to detect potential differences in Beta-thromboglobulin levels between the two groups at T2. Other coagulation and platelet function parameters were analyzed as secondary endpoints.

RESULTS: Beta-thromboglobulin increased significantly at T2 in both groups. However, there was no significant difference between the groups across all time points. There was no difference in the secondary endpoints between the groups.

CONCLUSIONS: The two circuits showed similar biological effects on platelet function and coagulation. This observation may be useful in optimizing the conduct of CPB and in rationalizing its cost for the treatment of CHD.

Original languageEnglish
JournalAnnals of Thoracic Surgery
DOIs
Publication statusE-pub ahead of print - Nov 2 2018

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