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Differences in blood activation related to roller/centrifugal pumps and heparin coated/uncoated surfaces in a cardiopulmonary bypass model circuit

Department of Cardiothoracic Surgery and Institute for Experimental Medical Research, Uilevaal Hospital

E. Fosse

Department of Cardiothoracic Surgery, Ullevaål Hospital, Oslo

J. Bråten

Department of Cardiothoracic Surgery, Ullevaål Hospital, Oslo

C. Andersson

Department of Cardiothoracic Surgery, Ullevaål Hospital, Oslo

K. Høgåsen

Institute for Immunology and Rheumatology, The National Hospital, University of Oslo, Oslo

TE Mollnes

Institute for Immunology and Transfusion Medicine, Nordland Central Hospital, Universitv of Tromsø, Tromso

P. Venge

Institute for Clinical Chemistry, University of Uppsala, Uppsala

P. Kierulf

Institute for Clinical Chemistry, Ullevaål Hospital, Oslo

An in vitro model cardiopulmonary bypass (CPB) circuit consisting ot tubing, oxygenator and venous reservoirs with either a roller or a centrifugal pump, and with either heparin-coated (Carmeda Bioactive Surface, CBAS) or uncoated surfaces, was studied with respect to 'blood activation', using small- scale-based blood volume (450 + 500 ml). Sixteen circuits were tested in each pump group, eight with and eight without heparin-coated surfaces, by circulating heparinized fresh human blood for 72 hours at 30°C. Blood plasma, sampled at defined intervals, was analysed for haemolysis (lactate dehydrogenase and potassium), complement activation (C3bc and C5b-9 (TCC)), complement lytic inhibitors (vitronectin and clusterin), coagulation activation (fibrinopeptide A), granulocyte (lactoferrin and myeloperoxidase) and platelet (ß-thromboglobulin) activation and contaminating endotoxin. The heparin coating significantly reduced the concentrations of C3bc, TCC, fibrinopeptide A, lactoferrin, myeloperoxidase and ß-thromboglobulin. The two pump types did not differ with respect to these parameters, but the roller pump caused significantly higher increases in plasma LDH and potassium and significantly greater reductions in clusterin and vitronectin than the centrifugal pump. Endotoxin concentration was low at the start and after 24 hours in all groups. These results confirm that heparin-coated CPB surfaces reduce blood activation, and suggest that centrifugal pumps cause less haemolysis and less reduction in lytic complement inhibitors than roller pumps.

Perfusion, Vol. 11, No. 2, 113-123 (1996)
DOI: 10.1177/026765919601100205


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