title: Prospective, randomized study comparing two different minimized versus conventional cardiopulmonary bypass systems.
abstract: OBJECTIVE
  Conventional cardiopulmonary bypass (CCPB) is a major trigger of inflammatory response. We aimed to assess the impact of two different minimized cardiopulmonary bypass systems (mini-CPB) with and without Bioline-coating compared with CCPB regarding organ function, inflammatory response, and early clinical outcome.
  
  
  METHODS
  In a prospective, randomized study, 120 patients underwent elective coronary artery bypass grafting and were randomized into three groups: mini-CPB using a Bioline-coated (group A, n = 40) or an uncoated (group B, n = 40) circuit, or CCPB (group C, n = 40). Cytokines (interleukin-6, interleukin-8, and tumor necrosis factor-alpha), myocardial markers (creatine kinase [CK], CK-MB, and troponin-T), hematocrit, and platelet counts were measured up to 48 hours postoperatively. Early clinical outcome was assessed at 3 months postoperatively.
  
  
  RESULTS
  Demographics, number of distal anastomoses, ventilation time, blood loss, intensive care unit, and hospital stay were comparable (P = not significant). Extracorporeal circulation and cross-clamp time were significantly longer in group A and B versus C (P < 0.005). No significant differences could be found in the release of interleukin-6, interleukin-8, and tumor necrosis factor-alpha among groups. Myocardial markers were significantly reduced in group A and B versus group C (P < 0.001). Hematocrit and platelet counts did not differ among the groups. No differences could be found in early clinical outcome up to 3 months.
  
  
  CONCLUSIONS
  This study showed significant better myocardial preservation with lower CK-MB and troponin-T levels in both mini-CPB groups. No significant differences could be found in terms of inflammation, hematologic effects, and early clinical outcome.
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Schoenebeck
authors.forename: Munif
authors.initials: M
authors.lastname: Haddad
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.forename: Elrina
authors.initials: E
authors.lastname: Joubert-Huebner
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Christian
authors.initials: C
authors.lastname: Detter