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Comparison of the effects of centrifugal versus roller pump on the immune response in open-heart surgery
J Perttilä1, M Salo, O Peltola
1Department of Anaethesiology, Turku University Central Hospital, Finland.
Insights
This study found no significant differences in immune responses between centrifugal and roller pumps during cardiopulmonary bypass in coronary artery bypass surgery patients. Both pump types induced comparable changes in immune markers.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Biomedical Engineering
Background:
- Cardiopulmonary bypass (CPB) is essential for cardiac surgery but can elicit immune responses.
- Different pump types used in CPB may influence these immune responses.
Purpose of the Study:
- To compare the effects of centrifugal and roller pumps on immune responses during CPB.
- To evaluate specific immune cell populations and function in patients undergoing coronary artery bypass surgery.
Main Methods:
- Randomized comparison of Biomedicus centrifugal pump versus Stöckert twin roller pump in 26 coronary artery bypass surgery patients.
- Measurement of leucocyte counts, lymphocyte subpopulations (CD3, CD4, CD8, CD16, CD20, CD25), monocyte counts (CD14), lymphocyte proliferation, immunoglobulin production (IgG, IgM, IgA), and plasma proteins (fibronectin, C-reactive protein, albumin).
- Samples collected preoperatively, before CPB, before aortic declamping, and on the first postoperative morning.
Main Results:
- Significant changes in measured immune variables were observed during CPB in both groups.
- No statistically significant differences in immune responses were detected between the centrifugal pump group and the roller pump group.
- Both pump types induced comparable alterations in leucocyte counts, lymphocyte subsets, and plasma protein concentrations.
Conclusions:
- Centrifugal and roller pumps elicit similar immune responses during cardiopulmonary bypass in coronary artery bypass surgery.
- The choice of pump type does not appear to significantly impact the measured immune system alterations in this patient cohort.
- Further research may explore other potential differences or long-term effects of pump types on patient outcomes.
Abstract:
We compared the effects of a centrifugal pump with those of a roller pump on immune responses in 26 coronary artery bypass surgery patients during cardiopulmonary bypass (CPB). The patients were randomly allocated into a (Biomedicus) centrifugal pump group and a (Stöckert) twin roller pump group. Leucocyte and differential counts; percentages of lymphocyte subpopulations (CD3-, CD4-, CD8-, CD16-, CD20- and CD25-positive lymphocytes) and monocytes (CD14); phytohaemagglutinin-, concanavalin A-, and pokeweed mitogen-induced and unstimulated proliferation of separated lymphocytes; unstimulated and pokeweed mitogen-stimulated production of IgG, IgM, or IgA; and plasma fibronectin, C-reactive protein and serum albumin concentrations were measured preoperatively, immediately before CPB, immediately before aortic declamping and on the first postoperative morning. Significant changes were seen in these variables, but no differences occurred between the groups.