SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery

Defraigne, Jean-Olivier; Pincemaïl, Joël; Dekoster, Guy; Larbuisson, Robert; Dujardin, M.; Blaffart, Francine; David, Jean-Louis; Limet, Raymond

doi:10.1016/s0003-4975(00)01838-5

Cited by 32 publications

(10 citation statements)

References 21 publications

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“…1,2 During CPB, interaction of blood with nonbiological surfaces or nondependent material factors (ischaemia -reperfusion of the heart and lungs, shed blood) triggers a strong inflammatory response, as reflected by increased levels of cytokines and leukocyte activation. [3][4][5][6][7][8][9][10][11][12] Moreover, allogeneic blood transfusion or intraoperative autotransfusion is sometimes required, contributing to further increased inflammatory response. 13,14 Many efforts are directed towards minimizing transfusion requirements with the use of specific protocols such as preoperative haemodilution, 15 adequate management of CPB, 8,[16][17][18][19] and pharmacological preservation of platelet function.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Many efforts are directed towards minimizing transfusion requirements with the use of specific protocols such as preoperative haemodilution, 15 adequate management of CPB, 8,[16][17][18][19] and pharmacological preservation of platelet function. 4,20 Recently, intraoperative blood salvage devices have been used during CPB, allowing the processing of shed and stagnant blood in the mediastinal cavity before reinfusion. The quality of such processed red cells has been widely demonstrated by several authors.…”

Section: Introductionmentioning

confidence: 99%

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Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit

et al. 2002

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Intraoperative blood salvage devices allowing a reinfusion of red blood cells (RBCs) after processing of shed blood and stagnant blood in the mediastinal cavity are more and more used to reduce homologous blood requirements in cardiac surgery with cardiopulmonary bypass (CPB). As the proinflammatory activity of the shed blood also contributes to morbidity during CPB, we conducted a prospective study in order to examine the quality of autologous blood before and after processing with five different devices [BRAT2, Sequestra, Compact Advanced, Cell Saver 5 (CS5), Continuous Autologous Transfusion System (CATS)]. All systems resulted in an excellent haemoconcentration, ranging from 53.7% (Compact) to 68.9% (CATS). The concentrations and elimination rates of several inflammatory markers [IL-1beta, IL-2, IL-8, TNFalpha, myeloperoxidase (MPO), elastase] were examined. Except for the Sequestra, an important increase in concentration of IL-1beta (between 30% and 220%) has been observed after processing with each device. In contrast, the attenuation rate of IL-6 and TNFalpha (95%) was optimal for all investigated blood salvages systems. Regarding IL-8, only the CATS and CS5 systems were able to attenuate this biological parameter with an excellent efficacy. The rate of attenuation in MPO and elastase, as markers of leukocyte activation, was higher than 80% for all devices. In conclusion, the different RBC washing systems tested in this study resulted in a significant attenuation of the inflammatory response. Increased levels of IL-1beta after processing remained, however, unclear. According to the type of protocol, based on inlet haematocrit, fill and wash speeds, and wash volumes, small variations in reducing the inflammatory response have been observed from one device to another.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit

et al. 2002

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“…In addition, despite carefully matched heparin doses, thrombin generation, as measured by the formation of thrombin AT III (TAT) was significantly decreased (ANOVA: p = 0.011). A similar clinical trial by Defraigne and colleagues confirmed the same degree of platelet preservation with SMA-CPB, a similar decreased release of βTG, as well as evidence of decreased need for transfusion of platelets and fresh frozen plasma [69]. A recent study by Allen and colleagues also reported lower blood loss in patients who underwent SMA-CPB, as well as improved preservation of blood pressure, especially in ACE inhibited patients [70].…”

Section: Surfaces With Modified Protein Adsorptionmentioning

confidence: 68%

Currently available biomaterials for use in cardiopulmonary bypass

Belway¹,

Rubens²

2006

Expert Review of Medical Devices

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Cardiopulmonary bypass (CPB) represents one of the most important technical innovations in healthcare history, yet the systemic responses to CPB remain a fundamentally unresolved problem. Study of the blood-biomaterial interaction and development of biocompatible materials is intimately related to efforts to optimize patient outcome following CPB. This article reviews the design innovations in biomaterial surfaces that have been introduced into clinical practice in an attempt to ameliorate the detrimental consequences of CPB, contrasting the actual clinical improvements and patient benefits achieved against those predicted on the basis of theory and in vitro testing. Some discussion of the underlying mechanisms of action as presently understood is provided and the current limitations of biomaterial-dependent strategies to improve outcome following CPB are addressed.

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“…Other efforts to attenuate the SIRS include heparin & poly-2-methoxyethylacrylate (PMEA) coating of CPB apparatus. Surface-modifying additives (SMA) technology is another alternative surface coating (family of polysiloxane-containing copolymers) which can be either blended with base polymer resins before processing or coated to blood-contacting surfaces, are in their initial stages of studies [32][33][34][35][36][37][38][39][40] .…”

Section: Modified Circuitsmentioning

confidence: 99%

Cardiopulmonary Bypass induced Fever and Systemic inflammatory response syndrome in Paediatric patients: Management Strategy

Ghatnatti

Teli

Bhattacharya

et al. 2013

Int J of Biomed & Adv Res

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Cardiopulmonary bypass is considered to be the common culprit for the occurrence of fever in the immediate post-operative period i.e, within 24 hours in pediatric patients. Other common causes contributing to fever are anaesthetic drugs, blood transfusions & pain. This early fever usually manifests as tachy-arrthymias in recovery room requiring interventions. This review intends to know the pathophysiology of fever and systemic inflammatory response syndrome after bypass (SIRAB) onset, preventive aspects and better management of the fever in the post-operative period.

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SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery

Cited by 32 publications

References 21 publications

Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit

Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit

Currently available biomaterials for use in cardiopulmonary bypass

Cardiopulmonary Bypass induced Fever and Systemic inflammatory response syndrome in Paediatric patients: Management Strategy

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