SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery.
BACKGROUND
Platelet count and function are particularly damaged by cardiopulmonary bypass (CPB). This study evaluated the effects of a novel CPB circuit in terms of platelet count and activation, and postoperative need for blood products.


METHODS
One hundred patients undergoing coronary grafting were randomized in two groups: control group (n = 50) and test group (n = 50, surface modifying additives circuit, SMA group). Blood samples were taken before, during, and after CPB. Postoperative blood loss, number of transfused blood products, and postoperative variables were recorded.


RESULTS
The platelet count decreased less in the SMA group compared to the control group (end of CPB: respectively, 165 +/- 9 x 10(3)/mm3 vs 137 +/- 8 x 10(3)/mm3; p < 0.01). This was paralleled by a reduction in beta-thromboglobulin plasma levels in the SMA group. There was a trend to decreased blood loss in the SMA group, but the difference was significant only in patients taking aspirin preoperatively (p < 0.05). In the SMA group nearly 50% less fresh frozen plasma and platelet units were administered (p < 0.01). No operative deaths were observed.


CONCLUSIONS
The use of circuits with surface additives is clinically safe, preserves platelet levels, and attenuates platelet activation. This may lead to a reduced need for blood products.
Defraigne
J O
JO
Department of Cardiovascular Surgery, Center for Experimental Surgery, University Hospital of Liège, Belgium. jo.defraigne@chu.ulg.ac.be
Pincemail
J
J
Dekoster
G
G
Larbuisson
R
R
Dujardin
M
M
Blaffart
F
F
David
J L
JL
Limet
R
R
D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D010976:Platelet Count; D013499:Surface Properties; D001620:beta-Thromboglobulin / Q000378:metabolism
D001620:beta-Thromboglobulin