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Comparison of a Duraflo II-coated cardiopulmonary bypass circuit and a trillium-coated oxygenator during open-heart surgery

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway, tom.nilsen.hoel{at}rikshospitalet.no

Vibeke Videm

Department of Immunology and Transfusion Medicine, Trondheim University Hospital and Institute of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway

Svein T Baksaas

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway

Tom E Mollnes

Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway

Frank Brosstad

Research Institute for Internal Medicine, Rikshospitalet University Hospital, Oslo, Norway

Jan L Svennevig

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway

Background: Cardiopulmonary bypass (CPB) evokes a systemic inflammatory response. In attempting to improve the biocompatibility of the equipment, various methods to coat the inner surfaces of the CPB systems have been developed. The present study compares a Trillium Biopassive surface-coated Affinity oxygenator with a Duraflo II totally heparin-coated CPB system.

Methods: Low-risk patients admitted for primary coronary artery bypass grafting or aortic valve replacement were randomized to operation using the Trillium- or the Duraflo II-coated setups. Heparin concentration, complement activation (C3bc activation products and terminal complement complex (TCC)), platelet activation (platelet numbers and beta-thromboglobulin (BTG)), leukocyte activation (leukocyte numbers and myeloperoxidase (MPO)), coagulation (thrombin/antithrombin complexes (TAT)) and fibrinolytic activity (plasmin/a₂-antiplasmin complexes (PAP)) were measured during CPB and two hours postoperatively.

Results: Platelet counts decreased during CPB, without significant intergroup differences. The median BTG concentration increased moderately in both groups and were slightly higher in the Trillium group during CPB (p B-0.05), but not postoperatively. Complement activation products (C3bc and TCC), leukocyte counts, MPO, TAT and PAP activity showed no differences between the two groups.

Conclusions: There were small differences in the inflammatory response between the two extracorporeal circulation devices compared in this study.

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