title: The inflammatory response between miniaturised and conventional cardiopulmonary bypass after cardiac surgery in an Asian population.
abstract: BACKGROUND
  We compared the systemic inflammatory response of the MCPB system to the CCPB system with cell salvage and phosphorylcholine-coated tubing amongst Asian patients undergoing coronary artery bypass grafting.
  
  
  METHODS
  Seventy-eight patients were randomly assigned to the MCPB or the CCPB groups equally and followed up in a prospective, single-blinded, randomised, controlled trial. Levels of TNF-α, IL-6, CRP and LDH were measured peri-operatively.
  
  
  RESULTS
  The systemic inflammatory response was similar in both groups (TNF-α: p=0.222; IL-6: p=0.991; CRP: p=0.258). Only haemolysis was significantly higher in the CCPB group (LDH: p=0.011). The MCPB system was twice more expensive, but had a near 4-fold cost saving in tranfusions. Overall, the MCPB system cost 20% more than the modified CCPB system.
  
  
  CONCLUSIONS
  These results corroborate with studies that demonstrated the avoidance of cardiotomy suction rather than the MCPB system, itself, leads to an attenuated inflammatory response. The absence of obvious clinical benefit and the higher costs involved with the MCPB system would preclude its routine use.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: R R G
authors.initials: RR
authors.lastname: Ng
authors.affiliation: Department of Anaesthesiology, Singapore General Hospital, Singapore Department of Cardiovascular and Metabolic Disorders, Duke-National University of Singapore Graduate Medical School, Singapore.
authors.forename: S T H
authors.initials: ST
authors.lastname: Chew
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore.
authors.forename: P
authors.initials: P
authors.lastname: Ong
authors.affiliation: Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore.
authors.forename: M G
authors.initials: MG
authors.lastname: Caleb
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore Department of Anaesthesia, National University Health System, Singapore lian_kah_ti@nuhs.edu.sg.
authors.forename: L K
authors.initials: LK
authors.lastname: Ti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002097:C-Reactive Protein / Q000378:metabolism*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase
keywords: cardiopulmonary bypass; coronary artery bypass grafting; cost analysis; haemolysis; inflammation; miniaturised