Comparison of two different minimized extracorporeal circulation systems: hematological effects after coronary surgery.
Cardiopulmonary bypass induces hemolysis and activation of inflammatory and coagulation systems as a result of a combination of mechanical trauma and biological mechanisms. The aim of our study was to evaluate the performance of two different minimized extracorporeal circulation (ECC) systems and to compare their influence on blood components. From January 2003 to December 2008, 1,218 patients underwent coronary artery bypass grafting with minimized ECC. The PRECiSe system (41%) consists of a microporous capillary membrane oxygenator (MO) and a diagonal pump (DeltaStream DP2). The MECC system (59%) is composed of a polymethylpentene MO with a plasma-tight diffusion membrane and a centrifugal pump (RotaFlow). Serial blood samples were taken preoperatively (T0), on arrival to intensive care unit (T1), 6 hours postoperatively (T2), and at discharge (T3). Demographic data, intraoperative, and technical parameters were similar in both groups. At T1 and T2, the platelet count in the PRECiSe group was significantly lower than that in the MECC group (p < 0.01). Furthermore, at T1, levels of lactate dehydrogenase were significantly higher in the PRECiSe group (p < 0.05). In addition, postoperative blood loss was significantly higher using the PRECiSe system (p < 0.05). In conclusion, cardiac surgery with the MECC system is associated with less postoperative bleeding and improved blood cell preservation.
Haneya
Assad
A
Department of Cardiothoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany. assadhaneya@web.de
Philipp
Alois
A
Diez
Claudius
C
Ried
Michael
M
Puehler
Thomas
T
Camboni
Daniele
D
Zausig
York
Y
Lehle
Karla
K
Schmid
Christof
C
D001026:Coronary Artery Bypass / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D010976:Platelet Count; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies
D007770:L-Lactate Dehydrogenase