Heparin-bonded circuits: clinical outcomes and costs

Abstract

The aim of this study was to use meta-analysis to combine the results of numerous studies and examine the impact of heparin-bonded circuits on clinical outcomes and the resulting costs. Heparin-bonded circuits, both ionically and covalently bonded, are examined separately.The results of the study provide evidence that heparin-bonded circuits result in improved clinical outcomes when compared to the identical nonheparin-bonded circuits. These improved clinical outcomes result in subsequent lower costs per patient with their use. However, differences are apparent in the significance and magnitude of these outcomes between ionically and covalently bonded circuits. Covalently bonded circuits provide a greater magnitude and significance of improvement in clinical outcomes than ionically bonded circuits. Total cost savings can be expected to be three times greater with covalently bonded circuits ($3231 versus $1068).It was concluded that the choice regarding the use of a heparin-bonded circuits and the type of heparin-bonded circuit used has the potential to alter clinical outcomes and subsequent costs. Cost consideration cannot be ignored, but clinical benefits should be the main rationale for the choice of cardiopulmonary bypass circuit. This analysis provides evidence that clinical benefits and cost savings can both be derived from use of the same technology -covalently bonded circuits.

Clinical significance of coated extracorporeal circuits: a review of novel technologies

“…The significance of showing biocompatibility through reduced biologic markers has not correlated with measurable clinical benefit of surface modification during CPB. 12 In our study, we tested from 10 to 35 patients for each group. We have also chosen three-vessel coronary artery patients who underwent about 60 min of CPB.…”

Cardiopulmonary bypass technology transfer: musings of a cardiac surgeon

“…This was translated into considerable potential cost-savings of approximately $1700 (US) per patient. A recently reported meta-analysis of trials comparing heparin-coated circuits and low heparin versus standard circuits with standard heparin, showed an estimated cost bene t of $3231 (US) per patient with covalently bonded circuits and $1068 (US) per patient with ionically bonded circuits [38].…”

Clinical efficacy of leukofiltration on cardiopulmonary bypass related inflammatory response: Fact or Foe?

“…Results on the early postoperative period were higher but never as high as to confirm severe infection. Immunosuppression that engendered with homologous blood transfusion was demonstrated by clinical data (20). Bacterial infection rate (wound, pulmonary, urinary, etc) is significantly related with transfused blood volume when controlling for other variables.…”