Improved biocompatibility of extracorporeal circulation by the use of auto-oxygenation instead of artificial oxygenator in perfusion circuit.
The aim of this study was to determine the biocompatibility of an auto-oxygenation technique of cardiopulmonary bypass. Forty patients undergoing coronary bypass surgery were studied in two groups: A (auto-oxygenation, patients' lungs used in cardiopulmonary bypass) and B (conventional technique of cardiopulmonary bypass with bubble oxygenator). The platelet count decreased to -73% of initial value in group B vs only -27% in group A, P less than 0.001. Platelet aggregation to ADP decreased slightly in group A and hardly at all in group B, P less than 0.001. A transpulmonary leukocyte sequestration was greater in group B: 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group A, P less than 0.001. The level of C3a increased in group A from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml and in group B from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, P less than 0.001, but in group A the levels were significantly less, P less than 0.001. The current study clearly confirms the superior biocompatibility of cardiopulmonary bypass with lung over oxygenator.
Bochenek
A
A
Cardiothoracic Surgery Department, Silesian Heart Center, Katowice, Poland.
Religa
Z
Z
Kustosz
R
R
Wnuk-Wojnar
A M
AM
Wnuk
R
R
Wojnar
J
J
Woś
S
S
Wites
M
M
Zembala
M
M
Spyt
T
T
D001672:Biocompatible Materials; D001760:Bleeding Time; D001792:Blood Platelets / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D003167:Complement Activation; D005112:Extracorporeal Circulation / Q000009:adverse effects / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D008422:Materials Testing; D008875:Middle Aged; D010106:Oxygenators; D010976:Platelet Count
D001672:Biocompatible Materials; D006454:Hemoglobins