Are minimized perfusion circuits the better heart lung machines? Final results of a prospective randomized multicentre study

El-Essawi, Aschraf; Hájek, Tomáš; Skorpil, J; Böning, Andreas; Sabol, František; Ostrovsky, Yuri; Hausmann, Harald; Harringer, Wolfgang

doi:10.1177/0267659111419035

Cited by 50 publications

(51 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, Anastasiadis et al reported in their large meta‐analysis of 24 studies and c. 2800 patients that MiECC reduced the occurrence of POAF from 27.6% to 19.2% 20 . Correspondingly, of the four randomized trials comparing MiECC and CECC, two reported that MiECC was associated with 33%‐38% reduction in the development of POAF 21,22 . In the study by El‐Essawi, the incidence of POAF reduced from 24.2% to 16.3%, and in the study by Anastasiadis from 53.3% to 33.3%.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Impact of minimal invasive extracorporeal circulation on atrial fibrillation after coronary artery bypass surgery

et al. 2020

View full text Add to dashboard Cite

Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery with an incidence between 15% and 50% and pathophysiology not fully known. By choosing the method of extracorporeal circulation with focus on the reduction of systemic inflammatory response, one can potentially decrease the risk of POAF. In this prospective, randomized trial, we compared minimal invasive extracorporeal circulation (MiECC) with conventional extracorporeal circulation (CECC) in the prevention of POAF after coronary artery bypass surgery (CABG). A total of 240 patients who were scheduled for their first on‐pump CABG, were randomized to MiECC or CECC. The primary outcome measure was the incidence of first POAF during the first 84 hours after surgery. POAF occurred in 42/120 (35.0%) MiECC patients and 43/120 (35.8%) CECC patients with nonsignificant difference between the groups (OR 1.043, 95% CI 0.591‐1.843, P = .884). The first postoperative creatine kinase‐MB mass (CK‐MBm) value was lower in the MiECC group, 13.95 [10.5‐16.7] (median [IQR]) than in the CECC group, 15.30 [11.4‐18.9] (P = .036), whereas the use of perioperative dobutamine was higher in the MiECC group, 18/120 (15.0%), than in the CECC group 8/120 (6.7%) (P = .038). The incidence of a stroke, perioperative myocardial infarction, and resternotomy caused by bleeding did not differ in the MiECC and CECC groups. Age (OR 1.08, 95% CI 1.04‐1.13, P = .000) and peak postoperative CK‐MBm (OR 1.57, 95% CI 1.06‐2.37, P = .026) were independent predictors of POAF. MiECC compared to CECC was not effective in reducing the incidence of POAF in patients undergoing CABG.

show abstract

Section: Discussionmentioning

confidence: 88%

“…In our study, as well as in all the aforementioned studies patients undergoing CABG with no additional surgery were studied. In spite of this, the incidence of POAF in the reference group (CECC) has ranged considerably, from 19% to 53% 17,21‐24 . This most probably depicts different definition of POAF used in these trials.…”

Section: Discussionmentioning

confidence: 96%

Impact of minimal invasive extracorporeal circulation on atrial fibrillation after coronary artery bypass surgery

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In our study we found earlier rise of the CRP and procalcitonin levels as well as leukocyte count in the 'mini-CPB' group than in the control group by approximately 24 h, with a gradual decrease thereafter in both groups. Higher average levels of inflammatory markers in the 'mini-CPB' group This is related to higher HGB and HCT levels after the 'mini-CPB' procedure is conducted [4,5]. This significantly smaller decrease in HCT level is caused by minimal haemodilution.…”

Section: Discussionmentioning

confidence: 94%

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Mak¹,

Smolka

Kowalski

et al. 2016

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator, and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with the patient's own blood has a fundamental impact on the outcome. Aim:A comparison of cardiopulmonary bypass filled with the patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids.Methods: Non-randomised trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with use of cardiopulmonary bypass system with the patient's own blood priming, and a control group operated on with standard technique. Levels of haemoglobin (HGB), haematocrit (HCT), platelets, leukocytes, creatinine, protein, C-reactive protein, procalcitonin, volume of transfused blood products, postoperative drain output, time to extubation, and consumption of catecholamines were compared. Results:The results of a study comparing the classical system with the blood-filled system (n = 60) showed a significantly smaller decrease in HGB and HCT levels (p = 0.001), resulting in reduction of blood product transfusions by 75% (p = 0.03). The new type of extracorporeal circulation reduced the total postoperative drain output by approximately 28% (p = 0.003). The systemic inflammatory response syndrome (SIRS) was less pronounced and the tissue perfusion was better due to smaller degree of haemodilution leading to better organ and heart protection. The patients required shorter mechanical ventilation times in the perioperative period. Conclusions:The use of a new system of cardiopulmonary bypass filled with the patient's blood reduces the postoperative decrease in HGB and HCT, the amount of transfused blood products, and total postoperative drain output. It also shortens the time spent on mechanical ventilatory support.

show abstract

“…Indeed, there are only three with more than 100 patients randomized in each arm [9][10][11]. (Table 1) is a comparison of these three larger randomized trials with at least 100 patients comparing M-CPB to C-CPB.…”

Section: Common Features To M-cpbmentioning

confidence: 99%

“…(Table 1) is a comparison of these three larger randomized trials with at least 100 patients comparing M-CPB to C-CPB. Two of the studies [9,10] demonstrate a clear benefit with respect to bleeding and transfusion either in the OR, the first 24 hours, or in actual reoperations for bleeding. After isolated CABG with conventional CPB (C-CPB) it has been well demonstrated in large studies that perioperative red blood cell (RBC) transfusion is an important factor in postoperative mortality, infection, ischemic postoperative morbidity, hospital stay, and hospital costs [12].…”

Section: Common Features To M-cpbmentioning

confidence: 99%

Advantages to Miniaturized Cardiopulmonary Bypass for Adult Cardiac Surgery

Chatterjee

2013

J Clin Exp Cardiolog

View full text Add to dashboard Cite

Are minimized perfusion circuits the better heart lung machines? Final results of a prospective randomized multicentre study

Abstract: 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.

Cited by 50 publications

References 23 publications

Impact of minimal invasive extracorporeal circulation on atrial fibrillation after coronary artery bypass surgery

Impact of minimal invasive extracorporeal circulation on atrial fibrillation after coronary artery bypass surgery

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Advantages to Miniaturized Cardiopulmonary Bypass for Adult Cardiac Surgery

Contact Info

Product

Resources

About