First experience with closed circuit/centrifugal pump extracorporeal circulation: cellular trauma, coagulatory, and inflammatory response

Abstract

Closed circuit extracorporeal circulation comprising a centrifugal pump has been developed to reduce deleterious effects of standard cardiopulmonary bypass. This study compares such a system with standard extracorporeal circulation (ECC). Twenty patients underwent isolated routine coronary artery revascularization. Ten patients underwent ECC. Ten patients were operated upon using a closed circuit/centrifugal pump system with coated surfaces (ISS) (SYNERGY, Stöckert). Both groups did not differ regarding age, body mass, left ventricular function, number of bypasses, and concomitant diseases. Free hemoglobin (fHb), plasmin-antiplasmin complex (PAPc), platelet function (ROTEG), and interleukin 6 (IL-6) were measured preoperatively, intraoperatively (after sternotomy, during X-Clamp, during reperfusion, post ECC or ISS), and postoperatively. Technical problems were not observed. The ISS group demonstrated significantly less fHb during bypass, a lower intraoperative myocardial damage as well as less increase in IL-6 after bypass and postoperatively compared to ECC. In ISS fluid balance was significantly lower than in ECC whereas drainage loss and hospitalization did not differ statistically. Extracorporeal circulation with a closed circuit/centrifugal pump system can be routinely employed and appears to be safe. Intraoperative and early postoperative reduction of red blood cell trauma and inflammation are of potential value.

No clear clinical benefit of using mini-invasive extracorporeal circulation in coronary artery bypass grafting in low-risk patients

“…In comparison to the effect of mini�systems, there are published materials which confirm significantly lower values of IL� 6 while using mini�ECC. 18 However, a larger number of studies did not find any significant difference. 15,16 Our findings are statistically significant at the end of ECC, which shows possible lower immune activation during mini� ECC.…”

The effect of using the minimized cardio-pulmonary bypass Systems for Coronary Artery Bypass Grafting in diabetic patients

“…Inflammatory response activation may contribute to myocardial dysfunction, respiratory failure, renal insufficiency, confusion or stroke, atrial fibrillation and coagulopathy [1,2]. Multiple studies noted a decrease in the inflammatory response with Mini-Bypass circuits [2,13,19,25,26]. The rationale of miniaturization of extracorporeal circuits is to reduce foreign surfaces as well as priming volume and, therefore, to limit SIR and alterations in perioperative hemostasis.…”

The Effect of Using the Minimized Cardio-pulmonary Bypass Systems for Coronary Artery Bypass Grafting in Diabetic Patients

“…In ammatory response activation may contribute to myocardial dysfunction, respiratory failure, renal insu ciency, confusion or stroke, atrial brillation and coagulopathy [1,2]. Multiple studies noted a decrease in the in ammatory response with Mini-Bypass circuits [2,13,19,25,26].…”