title: Impact of minimized extracorporeal circulation on outcome in patients with preoperative anemia undergoing coronary artery bypass surgery.
abstract: Preoperative anemia and low hematocrit during cardiopulmonary bypass have been associated with worse outcome in patients undergoing cardiac surgery. The minimized extracorporeal circulation (MECC) allows a reduction of the negative effects associated with conventional extracorporeal circulation (CECC). In this study, the impact of the MECC on outcome of anemic patients after coronary artery bypass grafting (CABG) was assessed. Between January 2004 and December 2011, 1,945 consecutive patients with preoperative anemia underwent isolated CABG using CECC (44.8%) or MECC (55.2%). The cutoff point for anemia was 13 g/dl for men and 12 g/dl for women. The postoperative creatine kinase and lactate levels were significantly lower in the MECC group (p < 0.001). There was no difference in postoperative blood loss between the groups. However, the intraoperative and postoperative transfusion requirements were significantly lower in the MECC group (p < 0.05). Furthermore, MECC patients had lower incidences of postoperative acute renal failure, and low cardiac output syndrome, shorter intensive care unit lengths of stay and reduced 30-day mortality (p < 0.05). In conclusion, a reduced postoperative mortality, lower transfusion requirements, and less renal and myocardial damage encourage the use of MECC for CABG, especially in the specific high-risk subgroup of patients with anemia.
authors: Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. assadhaneya@web.de
authors: Assad
authors: A
authors: Haneya
authors: Alois
authors: A
authors: Philipp
authors: Marietta
authors: M
authors: Von Suesskind-Schwendi
authors: Claudius
authors: C
authors: Diez
authors: Stephan W
authors: SW
authors: Hirt
authors: Philipp
authors: P
authors: Kolat
authors: Tim
authors: T
authors: Attmann
authors: Jan
authors: J
authors: Schoettler
authors: York
authors: Y
authors: Zausig
authors: Michael
authors: M
authors: Ried
authors: Christof
authors: C
authors: Schmid
mesh_terms: D000368:Aged; D000740:Anemia / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005112:Extracorporeal Circulation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome