A prospective, randomized platelet-function study of heparinized oxygenators and cardiotomy suction.
OBJECTIVE
The purpose of this study was to determine if substitution of a heparin-coated oxygenator and salvaged autologous blood for cardiotomy suction would improve platelet function.


METHODS
A prospective, randomized trial.


METHODS
A large academic medical center.


METHODS
Sixty adult patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass (CPB).


METHODS
Patients were randomized into 1 of 4 groups in a 2 x 2 factorial design by oxygenator (heparinized v nonheparinized) and blood salvage during CPB (cardiotomy suction v salvaged autologous blood).


RESULTS
Primary outcome measures were platelet function, glass-bead retention, platelet dense-body adenosine triphosphate secretion, platelet-rich plasma (PRP) aggregometry, Plateletworks platelet-function analyzer (Helena Laboratories Corp, Allen Park, MI), and platelet count. Secondary outcome measures were chest-tube drainage and allogeneic blood transfusion requirements. All platelet-function tests except thrombin-receptor activator peptide-induced PRP aggregometry showed a reduction in platelet function during and immediately after CPB (all p < 0.05). The only statistically significant difference in platelet-function tests between the groups was the glass-bead assay at 5 minutes before discontinuation of CPB (p < 0.05). This difference resolved 10 minutes after protamine administration. There were no differences between the groups in the amount of blood transfused, chest-tube drainage, and routine laboratory test results.


CONCLUSIONS
The authors concluded that the effects of these changes to the CPB circuit were small and inconsequential in this cohort of patients.
Nuttall
Gregory A
GA
Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. nuttall.gregory@mayo.edu
Oliver
William C
WC
Fass
David N
DN
Owen
Whyte G
WG
Dinenno
Devin
D
Ereth
Mark H
MH
Williams
Brent A
BA
Dearani
Joseph A
JA
Schaff
Hartzell V
HV
D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass; D015505:Chest Tubes; D020099:Coated Materials, Biocompatible; D001026:Coronary Artery Bypass; D005260:Female; D006493:Heparin; D006801:Humans; D008297:Male; D010107:Oxygenators, Membrane; D010974:Platelet Aggregation; D010976:Platelet Count; D010979:Platelet Function Tests; D013396:Suction
D020099:Coated Materials, Biocompatible; D006493:Heparin