This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kofidis, T Articles by Klima, U Search for Related Content PubMed PubMed Citation Articles by Kofidis, T Articles by Klima, U Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Coronary Artery Bypass Surgery Coronary Artery Disease Social Bookmarking                   What's this?

The minimized extracorporeal circulation system causes less inflammation and organ damage

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany; Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital, Singapore surtk{at}nus.edu.sg

H Baraki

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

H Singh

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

H Kamiya

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

M Winterhalter

Department of Anesthesiology, Hannover Medical School, Hannover, Germany

V Didilis

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

M Emmert

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

F Woitek

Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany

A Haverich

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany

U Klima

Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany; Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital, Singapore

The minimized extracorporeal circulation system (MECC) is being used to reduce priming volume and blood/polymer contact during cardiac procedures. In this study, we evaluated the efficacy and potential advantages of the system in coronary artery bypass graft (CABG) patients. We included two groups of patients destined for CABG in a prospective, randomized study: Group A was operated on the usual pump (n = 30) while Group B was operated using the MECC (n = 50). Pre-operative demographics, intra-operative times and values as well as a series of post-operative outcome data (blood loss, transfusion requirements, ventilation time, ICU and hospital stay) were recorded. CK, CK-MB, troponin-T, IL-6 and IL-8 were measured. Pre-operative and post-operative lung function were assessed. In the MECC-operated group, patients developed less post-operative troponin-T (0.2 ± 0.3 vs. 0.5 ± 0.5 ng/mL, p=0.031) and less IL-8 (13.8 ± 5 vs. 22.5 ± 0.5 µg/L, p = 0.05). While blood loss was comparable in both groups, packed red blood cells and fresh frozen plasma were given less frequently in the MECC group (p = 0.015 resp. 0.022). The one-tailed Student’s t-test revealed shorter bypass time in the MECC group (74 ± 17 vs. 82 ± 24 min). There was no difference in ventilation and ICU-time (patients were not treated in a fast-track fashion). The FEV1 was better in the MECC group (relative values: 70.1 ± 18.2% vs. 61.1 ± 12.3%, p = 0.02). Utilization of the MECC may cause less cytokine (IL-8) liberation, owing to less blood/tubing contact, as well as less red blood cell and fresh frozen plasma demand. It may also be the circuit in patients with chronic obstructive pulmonary disease (COPD).

Key Words: cardiopulmonary bypass • extracorporeal circulation • minimally invasive

Perfusion, Vol. 23, No. 3, 147-151 (2008)
DOI: 10.1177/0267659108097880


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?