Comparison of the standard roller pump and a pulsatile centrifugal pump for extracorporeal circulation during routine coronary artery bypass grafting

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Extracorporeal circulation is vital for coronary artery bypass grafting (CABG).
• Arterial pumps are critical components of extracorporeal circuits.
• Comparing roller and centrifugal pumps is essential for optimizing patient outcomes.

Purpose of the Study:

• To compare the performance of a standard nonpulsatile twin roller pump with a Sarns centrifugal pump during CABG.
• To evaluate haemodynamic profiles, oxygen exchange, and homeostasis between the two pump types.

Main Methods:

• Prospective study of 50 patients undergoing CABG, divided into two groups (25 each).
• Group 1: Standard nonpulsatile twin roller pump (R group).
• Group 2: Sarns centrifugal pump in pulsatile mode (C group).
• Investigated parameters: haemodynamics, oxygen exchange, blood gas homeostasis, haematology, coagulation, and complement consumption.

Main Results:

• No significant differences in main haemodynamic parameters during cardiopulmonary bypass (CPB).
• Centrifugal pump group required tenfold less sodium nitroprusside to maintain systemic vascular resistance.
• Higher oxygen extraction observed in the centrifugal pump group during rewarming.
• No differences in haemodynamics, oxygenation, blood gas homeostasis, blood loss, or transfusion requirements post-CPB.
• White blood cell count decreased in the roller pump group early in CPB, but not in the centrifugal pump group.

Conclusions:

• Centrifugal pumps may offer advantages in managing systemic vascular resistance during CPB for CABG.
• Both pump types demonstrate comparable haemodynamic and homeostatic performance during and after CABG.
• Further research into inflammatory responses associated with different pump types is warranted.