CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 8, 2003, No 1-2

Bioline or Safeline Treatment of CPB Circuits?
R. Feyrer, F. Harig, R. Cesnjevar, O. Faidi Mahmoud, H. Parsch, M. Doreth, T. Fischlein, M. Weyand

Background: Several clinical and biochemical studies have demonstrated improved biocompatibility of heparin coated extracorporeal circulation systems compared to uncoated systems. This study sought to analyze if heparin coated circuits are superior to protein treated systems.
Methods: 80 patients were included in a randomized double blind study. All patients underwent elective CABG. In 40 patients, a completely heparin coated perfusion system (Jostra Bioline) was used, in the remaining 40, the bypass circuit was protein treated (Jostra Safeline). Demographical and pre- and intraoperative data were identical in both groups. The study focused on the postoperative inflammatory response assessed by measuring levels of the biochemical markers C3 and IL-6 and by electrical bioimpedance analysis. All data were obtained preoperatively and 4h and 24h after CPB.
Results: Postoperative bioimpedance data (including total body water, intra- and extracellular water) showed no significant difference between the two surface treatments.
With heparin coated systems, complement factor C3 levels recovered significantly better after 24 hours.
IL-6 results were not significantly different between the two groups.
There was also no significant difference in any of the additional parameters and postoperative clinical data.
Conclusion: With protein treated systems, the postoperative inflammatory response to CPB is similar to the response to heparin coated circuits. It may be advantageous in cardiac surgical cases requiring long durations of CPB that C3 returns to baseline levels faster with heparin coated systems.
Safeline treated bypass circuits represent a good alternative, especially considering their cost-effectiveness.

Key words: heparin coating, bioline, safeline, cardiac surgery, CABG

Richard Feyrer, M.D.
Zentrum für Herzchirurgie
Universität Erlangen-Nürnberg
Krankenhausstr. 12
D-91054 Erlangen
Germany
E-mail: richard.feyrer@herz.imed.uni-erlangen.de

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