小児体外循環におけるミクロドメイン構造被覆体外循環回路の生体適合性について

概要

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Cardiopulmonary bypass (CPB) induces numerous systemic reactions in infants. The purpose of this study was to examine the biocompatibility of microdomain structural extracorporeal circuits in infants. Twenty-one ventricular septal defect patients undergoing elective cardiac surgery were randomly divided into three groups: group C; conventional circuit and oxgenator group (n=7), group M; microdomain structural circuit and heparin bonded oxygenator group (n=7), and group H; heparin bonded circuit and heparin bonded oxygenator group (n=7) . Measurements of blood cell count, fibrinogen, AT-III, D-dimer, bradykinin and complement system were made before CPB, after 5 min of CPB, just after CPB, 2 hr after CPB and 24 hr after CPB. There were significant differences for group M in platelet reduction (p<0.05) and AT-III reduction (p<0.05) between group M and group C or H. But there were no significant differences in fibrinogen reduction and D-dimer production. There tended to be less bradykinin generation in group M (p=0.06 vs group C and p=0.08 vs group H). And there tended to be less C3a activation in group M (p=0.08 vs group C and p=0.08 vs group H). The microdomain structure seemed to reduce systemic reactions compared with heparin bonded circuits and non-bonded circuits.
東京女子医科大学の論文
2000-12-25