Routine extracorporeal circulation with a centrifugal or roller pump.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Hematology

Background:

• Extracorporeal circulation (ECC) is crucial for cardiopulmonary support during cardiac surgery.
• Different arterial pumps, such as centrifugal pumps (CP) and roller pumps (RP), may impact blood elements differently.
• Understanding these impacts is vital for optimizing patient outcomes and minimizing complications like postperfusion syndrome.

Purpose of the Study:

• To compare the effects of centrifugal pumps (CP) versus roller pumps (RP) on blood elements during elective coronary artery bypass grafting (CABG).
• To assess markers of blood activation, including plasma hemoglobin (pHb), beta-thromboglobulin (beta-TG), D-dimer (D-D), and platelet counts.
• To evaluate the clinical relevance of pump-induced blood element changes on patient outcomes.

Main Methods:

• A randomized clinical trial involving 50 patients undergoing elective CABG.
• Patients were divided into two groups: Group I (CP) and Group II (RP).
• Blood samples were collected at multiple time points during and after ECC to measure various blood parameters and coagulation markers.

Main Results:

• Significant differences favoring the centrifugal pump (CP) were observed in plasma hemoglobin (pHb), beta-thromboglobulin (beta-TG), D-dimer (D-D), and platelet counts.
• These differences were time-dependent, becoming significant after 90 minutes of ECC and disappearing post-surgery.
• No significant differences were found in bypass time, ECC flow, fluid balance, patient outcome, or ICU stay between the groups.

Conclusions:

• Roller pumps (RP) can be safely used for routine extracorporeal circulation (ECC).
• Centrifugal pumps (CP) demonstrate superior blood compatibility, reducing blood activation markers during prolonged or complex cardiac procedures.
• The use of CP may be beneficial in complex cardiosurgical procedures to mitigate severe postperfusion syndrome.