Nejat SARIOSMANOĞLU, Erdem SİLİSTRELİ, Eyüp HAZAN, Hüdai ÇATALYÜREK, Ünal AÇIKEL, Hakkı KAZAZ, Öztekin OTO

Heparin kaplı sistemin pulmoner hasar üzerine etkilerini gösteren klinik çalışma

Bu çalışmanın amacı, heparin kaplı sistemin statik akciğer kompliansı ve pulmoner vasküler rezistans üzerine etkilerini değerlendirerek pulmoner hasara etkilerini incelemektir. Otuz hasta randomize olarak heparin kaplı ve heparin kaplı olmayan olarak iki ayrı gruba ayrılmıştır. Tüm heparin kaplı materyalde kanın etkileştiği tüm yüzeyler immobilize heparin ile kaplanmıştır (Duraflo II). Sonuç olarak erken postoperatif dönemdeki pulmoner fonksiyonları değerlendirmek için statik akciğer kompliyansı, pulmoner vasküler rezistans ve kan gazları değerlendirilmiştir. Heparin kaplı sistemde erken postop. dönemde statik akciğer kompliansı daha iyi olarak bulunmuştur (p=0.001). Yine pulmoner vasküler rezistans anlamlı olarak düşük bulunmuştur (p=0.001). Sonuç olarak heparin kaplı sistemin kompleman aktivasyonu ve şekilli kan elemanları üzerine etkisi bilinmekte ise de, pulmoner hasar üzerine olumlu yönde etkisinin olabileceği saptanmıştır.

The effects of heparin-coated circuits on pulmonary injury: A clinical study

Heparin-coated circuits have dramatic effects on the coagulation cascade, but their role on complement activation has not been clearly defined. In this clinical study, the effect on the heparin-coated circuits on static lung compliance and pulmonary vascular resistance was investigated. Thirty patients were randomly divided into two groups: with either a heparin-coated circuit or an identical but non-coated circuit control group. In the heparin-coated group, all the blood contacting surfaces were treated with immobilized heparin (Duraflo II). Early postoperative pulmonary function is determined with measurements of static lung compliance, pulmonary vascular resistance and arterial blood gases. Static lung compliance was significantly better in the heparin coated (HC) group in early postoperative period (p=0.001). Pulmonary vasculary resistance was significantly lower in the heparin-coated (HC) group in early postoperative period (p=0.001). We believe that the method of heparin binding may play a role in its diminished effect on complement activation, but the general augmentation of the circuits biocompatibility may explain its beneficial effect on pulmonary vascular resistance and static lung compliance.

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