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Updated: May 20, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Centrifugal pump and roller pump in adult cardiac surgery: a meta-analysis of randomized controlled trials
Richard Saczkowski1, Michelle Maklin, Thierry Mesana
1Department of Cardiac Surgery, Royal Columbian Hospital, New Westminster, British Columbia, Canada. richard.saczkowski@gmail.com
Insights
This meta-analysis found no significant clinical differences between centrifugal pumps (CP) and roller pumps (RP) in adult cardiopulmonary bypass. Outcomes like blood loss, transfusions, and mortality were similar, indicating comparable safety and efficacy.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Clinical Trials Methodology
Background:
- Centrifugal pumps (CP) and roller pumps (RP) are primary arterial pumps in cardiopulmonary bypass (CPB).
- Clinical outcome data comparing CP and RP have been controversial, necessitating further investigation.
Purpose of the Study:
- To conduct a meta-analysis evaluating clinical variables from randomized controlled trials (RCTs) comparing CP and RP in adult CPB.
- To determine if significant differences exist in patient outcomes between the two pump types.
Main Methods:
- Systematic keyword searches of Medline, EmBase, and CINAHL databases (1966-2011).
- Inclusion of 18 RCTs representing 1868 adult patients undergoing CPB, predominantly for coronary artery bypass graft surgery.
- Application of fixed-effects models to calculate pooled estimates for dichotomous and continuous data, assessing statistical significance with P < 0.05.
Main Results:
- No statistically significant differences were observed between CP and RP groups for hematological variables (platelet count, plasma free hemoglobin, white blood cell count, hematocrit) at end-of-CPB and postoperative day one.
- Postoperative blood loss, red blood cell transfusion requirements, intensive care unit length of stay, hospital length of stay, and mortality rates were similar between the two pump types.
- Neurologic outcomes were inconclusive due to limitations in pooled analysis, and no pump-related malfunctions were reported.
Conclusions:
- The meta-analysis suggests that centrifugal pumps and roller pumps demonstrate comparable safety and efficacy in adult cardiac surgery.
- There are no significant differences in key hematological parameters, blood loss, transfusion needs, neurological outcomes, or mortality between CP and RP.
- Both pump designs appear to be suitable for main arterial pumping in cardiopulmonary bypass without a clear advantage of one over the other based on current RCT evidence.
Abstract:
Centrifugal pump (CP) and roller pump (RP) designs are the dominant main arterial pumps used in cardiopulmonary bypass (CPB). Trials reporting clinical outcome measures comparing CP and RP are controversial. Therefore, a meta-analysis was undertaken to evaluate clinical variables from randomized controlled trials (RCTs). Keyword searches were performed on Medline (1966-2011), EmBase (1980-2011), and CINAHL (1981-2011) for studies comparing RP and CP as the main arterial pump in adult CPB. Pooled fixed-effects estimates for dichotomous and continuous data were calculated as an odds ratio and weighted-mean difference, respectively. The P value was utilized to assess statistical significance (P < 0.05) between CP and RP groups. Eighteen RCTs met inclusion criteria, which represented 1868 patients (CP = 961, RP = 907). The prevailing operation was isolated coronary artery bypass graft surgery (CP = 88%, RP = 87%). Fixed-effects pooled estimates were performed for end-of-CPB (ECP) and postoperative day one (PDO) for platelet count (ECP: P = 0.51, PDO: P = 0.16), plasma free hemoglobin (ECP: P = 0.36, PDO: P = 0.24), white blood cell count (ECP: P = 0.21, PDO: P = 0.66), and hematocrit (ECP: P = 0.06, PDO: P = 0.51). No difference was demonstrated for postoperative blood loss (P = 0.65) or red blood cell transfusion (P = 0.71). Intensive care unit length of stay (P = 0.30), hospital length of stay (P = 0.33), and mortality (P = 0.91) were similar between the CP and RP groups. Neurologic outcomes were not amenable to pooled analysis; nevertheless, the results were inconclusive. There was no reported pump-related malfunction or mishap. The meta-analysis of RCTs comparing CP and RP in adult cardiac surgery suggests no significant difference for hematological variables, postoperative blood loss, transfusions, neurological outcomes, or mortality.
