Cardiopulmonary bypass: it's not the size, it's how you use it! Review of a comprehensive blood-conservation strategy.
Several of the manufacturers of cardiopulmonary bypass equipment have recently introduced new miniature cardiopulmonary bypass systems. New advancements in cardiopulmonary bypass technology are almost always of interest to the perfusion community. However, the question arises, what advantages do these systems offer over our present technology? The manufacturers claim that these new systems will add to our perfusion armamentarium by offering us an opportunity to further reduce priming volume and the surface area to which the blood is exposed. Our group, in the Department of Cardiac Surgery at Boston Medical Center has been involved in the development of a comprehensive blood conservation strategy since 1994. Our published data clearly demonstrates improved clinical outcomes using coated circuit technology as part of a comprehensive blood conservation strategy. In an effort to clearly evaluate this new technology, in this article we review our current technique at Boston Medical Center.
Lilly
Kevin J
KJ
Department of Cardiothoracic Surgery, Brigham and Woman's Hospital/Cape Cod Hospital, Hyannis, MA 02601, USA. klilly@capecodhealth.org
O'Gara
Paul J
PJ
Treanor
Patrick R
PR
Reardon
Deborah
D
Crowley
Richard
R
Hunter
Curtis
C
Shapira
Oz M
OM
Aldea
Gabriel S
GS
Lazar
Harold L
HL
Shemin
Richard J
RJ
D000925:Anticoagulants / Q000008:administration & dosage*; D001781:Blood Component Removal; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001793:Blood Preservation; D002315:Cardiopulmonary Bypass / Q000295:instrumentation* / Q000379:methods; D016503:Drug Delivery Systems; D005112:Extracorporeal Circulation / Q000379:methods*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008904:Miniaturization; D010973:Platelet Adhesiveness; D010976:Platelet Count; D013396:Suction
D000925:Anticoagulants; D006493:Heparin