Four years' experience with a miniaturized extracorporeal circulation system and its influence on clinical outcome.
It has been suggested that the morbidity associated with cardiopulmonary bypass can be attributed in part to the blood-material and blood-air interactions in the extracorporeal circulation (ECC). A recently introduced minimized ECC-system (MECC System) should be able to reduce these negative effects associated with ECC. A retrospective analysis was performed comprising 485 patients who were operated on for elective coronary artery bypass grafting (CABG) using the MECC System with intermittent antegrade warm blood cardioplegia (group 1) from January 2000 to February 2004. A control group consisted of 485 patients (group 2) undergoing elective CABG in the same period using a conventional ECC and cold crystalloid cardioplegia. There were no significant differences between the two groups in terms of the duration of intubation following surgery, the length of intensive care unit-stay and the total hospital stay. Although the 30-day mortality was similar between the two groups, the incidence of postoperative complications and the perioperative use of blood products were significantly higher in the control group compared to the MECC group. The MECC System may serve as an alternative and less invasive approach to conventional ECC.
Wiesenack
Christoph
C
Department of Anesthesia, University Hospital Regensburg, Regensburg, Germany. christoph.wiesenack@klink.uni-regensburg.de
Liebold
Andreas
A
Philipp
Alois
A
Ritzka
Markus
M
Koppenberg
Joachim
J
Birnbaum
Dietrich E
DE
Keyl
Cornelius
C
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002314:Cardioplegic Solutions; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D004867:Equipment Design; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006324:Heart Arrest, Induced / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007430:Intraoperative Care; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008904:Miniaturization; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D014914:Whole Blood Coagulation Time
D002314:Cardioplegic Solutions; D006454:Hemoglobins; D014662:Vasoconstrictor Agents; D019344:Lactic Acid