title: Are minimized perfusion circuits the better heart lung machines? Final results of a prospective randomized multicentre study.
abstract: BACKGROUND
  Minimized perfusion circuits (MPCs), although aiming at minimizing the adverse effects of cardiopulmonary bypass, have not yet gained popularity. This can be attributed to concerns regarding their safety, as well as lack of sufficient evidence of their benefit.
  
  
  METHODS
  Described is a randomized, multicentre study comparing the MPC - ROCsafeRX to standard cardiopulmonary bypass in patients undergoing elective coronary artery bypass grafting and/ or aortic valve replacement.
  
  
  RESULTS
  Five hundred patients were included in the study (252 randomized to the ROCsafeRX group and 248 to standard cardiopulmonary bypass). Both groups were well matched for demographic characteristics and type of surgery. No operative mortality and no device-related complications were encountered. Transfusion requirement (333 ± 603 vs. 587 ± 1010 ml; p=0.001), incidence of atrial fibrillation (16.3% vs. 24.2%; p=0.03) and the incidence of major adverse events (9.1% vs. 16.5%; p=0.02) were all in favour of the MPC group.
  
  
  CONCLUSIONS
  These results confirm both the safety and efficacy of the ROCsafeRX MPC for a large variety of cardiac patients. Minimized perfusion circuits should, therefore, play a greater role in daily practice so that as many patients as possible can benefit from their advantages.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Klinikum Braunschweig, Braunschweig, Germany. aelessawi@aol.com
authors.forename: A
authors.initials: A
authors.lastname: El-Essawi
authors.forename: T
authors.initials: T
authors.lastname: Hajek
authors.forename: J
authors.initials: J
authors.lastname: Skorpil
authors.forename: A
authors.initials: A
authors.lastname: Böning
authors.forename: F
authors.initials: F
authors.lastname: Sabol
authors.forename: Y
authors.initials: Y
authors.lastname: Ostrovsky
authors.forename: H
authors.initials: H
authors.lastname: Hausmann
authors.forename: W
authors.initials: W
authors.lastname: Harringer
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006355:Heart-Lung Machine / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies