Beneficial effects of mini-cardiopulmonary bypass on hemostasis in coronary artery bypass grafting: analysis of inflammatory response and hemodilution.
We compared the inflammatory response, hemodilution, and blood loss in patients who underwent mini-cardiopulmonary bypass (CPB) or conventional CPB during coronary artery bypass grafting (CABG). Ninety-eight consecutive patients with ischemic heart disease were randomly assigned to mini-CPB (n = 34) or conventional CPB (n = 64). Interleukin (IL) -8 and neutrophil elastase levels were measured before and after surgery. Hemodilution during CPB, blood loss during and after surgery were also evaluated. Compared with the conventional group, the mini-CPB group had lower levels of IL-8 on postoperative day 1 (8.3 +/- 6.4 vs. 19 +/- 11 pg/mL, p = 0.016) and of neutrophil elastase on postoperative days 1 (127 +/- 52 vs. 240 +/- 100 microg/L, p = 0.013) and 2 (107 +/- 17 vs. 170 +/- 45 micro/L, p = 0.0001). The mini-CPB group also has less blood loss during (620 +/- 595 vs. 978 +/- 658 mL, p = 0.012) and after the operation (578 +/- 310 vs. 1,002 +/- 651 mL, p = 0.0034) and a hemodilution ratio of 14 +/- 2 vs. 25% +/- 3%, p < 0.0001. Thus, mini-CPB attenuated the inflammatory response and hemodilution, resulting in blood conservation in patients undergoing CABG.
Ohata
Toshihiro
T
Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Mitsuno
Masataka
M
Yamamura
Mitsuhiro
M
Tanaka
Hiroe
H
Kobayashi
Yasuhiko
Y
Ryomoto
Masaaki
M
Yoshioka
Yoshiteru
Y
Tsujiya
Noriko
N
Miyamoto
Yuji
Y
D000368:Aged; D016063:Blood Loss, Surgical; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D006438:Hemodilution; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D017202:Myocardial Ischemia / Q000601:surgery
D016209:Interleukin-8; D019272:Leukocyte Elastase