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Perfusion 14, 11–19. , Najib, A-K. 1997: Does heparin coating improve biocompatibility? A study on complement, blood cells and postoperative morbidity during cardiac surgery. Perfusion 12, 385–91. E. 1992: Heparin-coated circuits reduce activation of granulocytes during cardiopulmonary bypass – a clinical study. Journal of Thoracic and Cardiovascular Surgery 104, 642–7. , Thelin, S. 1997: Effects of heparin-coating of cardiopulmonary bypass circuits on leukocytes during simulated extracorporeal circulation.

1991: Physical and blood contacting characteristics of propyl sulphonate grafted biomer. Biomaterials 12, 3–12. Olsson, P. 1990: Non-thrombogenic systems for extracorporeal gas exchange. International Journal of Artificial Organs 13, 9. M. et al. 1999: Effect of Trillium Biopassive Surface coating of the oxygenator on platelet count during cardiopulmonary bypass. Perfusion 14, 473–9. J. et al. 2001: Effect of Carmeda BioActive Surface coating versus Trillium Biopassive Surface coating of the oxygenator on circulating platelet count drop during cardiopulmonary bypass.

It is perhaps the apparent contradictory scientific evidence that tends to discourage the majority of cardiac surgeons from the adoption of this technique (Taylor, 1995). Pulsatile blood flow is a natural and physiological concept, and has effects far beyond the simple delivery of blood to tissues. The key issue in favour of pulsatility over non-pulsatile flow is that of systemic vasoconstriction. , 1983; Taylor, 1995). Excessive vasoconstriction will cause inadequate blood flow to selected areas, with the potential for organ failure.

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