2004 Fiscal Year Final Research Report Summary

Effect of cardiopulmonary bypass on postoperative bleeding and systemic inflammatory response

Research Project

Project/Area Number	15591495
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Single-year Grants
Section	一般
Research Field	Thoracic surgery
Research Institution	JIKEI UNIVERSITY SCHOOL OF MEDICINE
Principal Investigator	HASHIMOTO Kazuhiro Jikei University School of Medicine, Professor, 医学部, 教授 (30172860)
Co-Investigator(Kenkyū-buntansha)	SAKAMOTO Yoshimasa Jikei University School of Medicine, Lecturer, 医学部, 講師 (90246405) NAGAHORI Ryuichi Jikei University School of Medicine, Assistant, 医学部, 助手 (50271309) OKUYAMA Hiroshi Jikei University School of Medicine, Assistant, 医学部, 助手 (80214089)
Project Period (FY)	2003 – 2004
Keywords	Cardiopulmonary bypass / Normothermia / Hypothermia / systemic inflammatory / Off-pump bypass
Research Abstract	Normothermic cardiopulmonary bypass(CPB) was beneficial in some instances for the prevention of bleeding after the open heart surgery, compared to hypothermic bypass. The heparin-coated circuit under the normothermic CPB suppressed subclinical plasma coagulation and fibrinolysis, and was effective for the prevention of platelet count and function. Addition of the aprotinin (100 million units) prime further preserved platelet function and offered the possibility of bringing about a further reduction in postoperative blood loss and blood requirements. Cardiac surgery with CPB has been considered the main causative markers of the proinflammatory responses. Patients were compared surrogate markers of inflammatory response in patients who underwent coronary bypass surgery with or without CPB. The significant elevation of elastase was observed in on-pump patients after the surgery ; however, other factors (complements, platelet activation, interleukin, elastase, and prostaglandin) were not different in the amount and course between the two groups. Regarding the aspect of systemic inflammatory response, the benefit of off-pump bypass was not demonstrated.