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Published on: June 28, 2019
Haematological effects of minimized compared to conventional extracorporeal circulation after coronary
Kyriakos Anastasiadis1, Christos Asteriou, Apostolos Deliopoulos
1Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece.
Insights
Minimized extracorporeal circulation (MECC) systems offer significant advantages over conventional cardiopulmonary bypass (CECC) during coronary artery bypass grafting (CABG) surgery. MECC reduces haemodilution and haemolysis, preserving coagulation and leading to quicker patient recovery.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Medical Device Technology
Background:
- Conventional extracorporeal circulation (CECC) circuits are associated with adverse hematological effects.
- Minimally invasive extracorporeal circulation (MECC) systems have emerged as a potential alternative.
- Patient outcomes in cardiac surgery can be influenced by extracorporeal circuit design.
Purpose of the Study:
- To prospectively evaluate the postoperative hematological effects of MECC compared to CECC in patients undergoing coronary artery bypass grafting (CABG).
- To assess the impact of MECC on hematological parameters and clinical recovery post-CABG.
Main Methods:
- Prospective randomized study involving 99 patients undergoing CABG surgery.
- Comparison of hematological profiles between patients using MECC and CECC systems.
- Evaluation of clinical outcomes including blood product requirements and intensive care unit (ICU) stay.
Main Results:
- MECC group demonstrated significantly less hemodilution (p=0.001) and hemolysis (p<0.001).
- Preservation of coagulation system integrity was better in the MECC group (p=0.01).
- Reduced bank blood requirements and quicker recovery (mechanical ventilation, ICU stay) were observed with MECC.
Conclusions:
- MECC systems attenuate the adverse hematological effects associated with conventional cardiopulmonary bypass circuits.
- MECC offers clinical benefits including reduced blood transfusions and faster patient recovery after CABG.
- MECC represents a favorable alternative to CECC for patients undergoing CABG surgery.
Abstract:
During the last decade, minimized extracorporeal circulation (MECC) systems have shown beneficial effects to the patients over the conventional cardiopulmonary bypass (CECC) circuits. This is a prospective randomized study of 99 patients who underwent coronary artery bypass grafting (CABG) surgery, evaluating the postoperative haematological effects of these systems. Less haemodilution (p=0.001) and markedly less haemolysis (p<0.001), as well as better preservation of the coagulation system integrity (p=0.01), favouring the MECC group, was found. As a clinical result, less bank blood requirements were noted and a quicker recovery, as far as mechanical ventilation support and ICU stay are concerned, was evident with the use of MECC systems. As a conclusion, minimized extracorporeal circulation systems may attenuate the adverse effects of conventional circuits on the haematological profile of patients undergoing CABG surgery.
