title: Blood-air interface during cardiopulmonary bypass.
abstract: The aim of this study was to compare the systemic blood activation with open and closed perfusion management during cardiopulmonary bypass. In 30 patients undergoing coronary artery bypass grafting, we prospectively studied systemic blood activation, blood loss and the need for donor blood. In 15 patients we used an open venous reservoir consisting of a hard shell venous reservoir with an integrated cardiotomy filter. In another 15 patients we used a totally closed venous reservoir consisting of a collapsible venous reservoir, no coronary suction, modified vent and cell saver. Venous blood samples were collected pre, post and 24 hours postoperatively. Sex, age and perfusion times were identical in both groups. There were no statistically significant differences in concentrations of FXIIa and C3a, amount of blood loss and need for donor blood. Interleukin-6 and Elastase levels showed trends toward a lesser inflammatory reaction in closed venous reservoir patients. Modification of perfusion management with optimized air management does not seem to be an effective strategy in reducing the inflammatory response and influencing the coagulation system in this small cohort.
authors.affiliation: Heartcenter Ludwigshafen, Cardiac Surgery, Klinikum Ludwigshafen, Germany. kiesslia@klilu.de
authors.forename: Arndt-H
authors.initials: AH
authors.lastname: Kiessling
authors.forename: Mahmud
authors.initials: M
authors.lastname: Khalil
authors.forename: Ohmed
authors.initials: O
authors.lastname: Assaf
authors.forename: Frank
authors.initials: F
authors.lastname: Isgro
authors.forename: Kai-U
authors.initials: KU
authors.lastname: Kretz
authors.forename: Werner
authors.initials: W
authors.lastname: Saggau
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D002408:Catheters, Indwelling; D015926:Complement C3a / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D015956:Factor XIIa / Q000378:metabolism; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood / Q000378:metabolism; D010976:Platelet Count; D011446:Prospective Studies
chemical_list: D015850:Interleukin-6; D015926:Complement C3a; D010196:Pancreatic Elastase; D015956:Factor XIIa