Heparin-bonded cardiopulmonary bypass circuits reduce the rate of red blood cell transfusion during elective coronary artery bypass surgery.
OBJECTIVE
This study compared the transfusion rates of patients treated with heparin-bonded circuits with the transfusion rates of patients treated with standard bypass circuits with and without -aminocaproic acid (EACA).


METHODS
Prospective double-blind (drugs), open trial (cardiopulmonary bypass circuits).


METHODS
University medical center.


METHODS
Seventy-one patients undergoing elective am admission coronary artery bypass graft surgery.


RESULTS
Patients were randomized to receive either heparin-coated cardiopulmonary bypass circuits (HBCPB), nonheparin-coated cardiopulmonary bypass circuits and EACA (EACPB), or nonheparin-coated bypass circuits and placebo (control). Patients were transfused if their hematocrit was <18% while on cardiopulmonary bypass or <25% at any time after the cardiopulmonary bypass period. The rate and number of transfused packed red blood cells (pRBCs), platelets, fresh frozen plasma, and cryoprecipitate were measured. A Fisher exact test showed that the transfusion rate was as follows: the HBCPB group (5.0%), the EACPB group (18.2%), and the control group (36%), (p = 0.034).


CONCLUSIONS
The heparin-bonded cardiopulmonary bypass-treated patients in this study received fewer pRBCs than did the control group. A nonsignificant reduction in the pRBC transfusion rate was found between those with heparin-bonded bypass circuits and those with standard circuits who received epsilon-aminocaproic acid.
Kreisler
Kenneth R
KR
Department of Anesthesiology, University of Kansas, Kansas City, KS 66160, USA. kkreisler@kumc.edu
Vance
Robert A
RA
Cruzzavala
Jose
J
Mahnken
Jonathan D
JD
D000368:Aged; D000614:Aminocaproates / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy*; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000614:Aminocaproates; D000925:Anticoagulants; D006493:Heparin