title: Allogeneic Blood Product Usage in Coronary Artery Bypass Grafting (CABG) with minimalized Extracorporeal Circulation System (MECC) Versus Standard On-Pump Coronary Artery Bypass Grafting.
abstract: OBJECTIVE
  Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization.
  
  
  METHODS
  Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC). ABPT and overall early postoperative complications were analyzed.
  
  
  RESULTS
  Operative mortality and morbidity were similar in both groups. ABPT in the MECC group was significantly lower than in the sECC group both intraoperatively (7.2 vs. 60.3% of patients p<0.001) and during the first five postoperative days (19.3 vs. 57.5%; p<0.001). "Skin to skin"- (214 ± 45 vs. 232 ± 45 min; p=0.012), cardiopulmonary bypass (CPB) - (82 ± 25 vs. 95 ± 26 min; p=0.014), and X-clamp- times (50 ± 16 vs. 56 ± 17 min; p=0.024) were significantly lower in the MECC group than in the sECC group. Length of ICU (intensive care unit) - and hospital stay were also significantly lower in the MECC group vs. the sECC group (26.7 ± 20.2 vs. 54.5 ± 68.9 h; p<0.001, and 12.0 ± 4.1 vs. 14.5 ± 4.6 days; p<0.001).
  
  
  CONCLUSIONS
  Application of MECC as on-pump coronary artery bypass graft (CABG) results in significantly lower ABPT as well as shorter ICU and in-hospital stay. In order to achieve these benefits of MECC autologous retrograde priming, Bispectral index (BIS) monitoring, intraoperative cell salvage, meticulous hemostasis and strict peri- and postoperative volume management are crucial.
authors: Department of General, Visceral, Thoracic and Vascular Surgery, Frankfurt-Höchst City Hospital, Höchst, Germany.
authors: M
authors: M
authors: Lisy
authors: Department of Anaesthesia and Intensive Care, University Hospital Tuebingen, Tuebingen, Germany.
authors: E
authors: E
authors: Schmid
authors: Department of Thoracic, Cardiac and Vascular Surgery, University Hospital Tuebingen, Tuebingen, Germany.
authors: J
authors: J
authors: Kozok
authors: Department of Anaesthesia and Intensive Care, University Hospital Tuebingen, Tuebingen, Germany.
authors: P
authors: P
authors: Rosenberger
authors: Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt am Main, Höchst, Germany.
authors: U A
authors: UA
authors: Stock
authors: Department of General, Visceral, Thoracic and Vascular Surgery, Frankfurt-Höchst City Hospital, Höchst, Germany.
authors: G
authors: G
authors: Kalender
keywords: Blood transfusion; Cardiopulmonary bypass; Coronary artery bypass graft; Extracorporeal circulation