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Less blood damage in the impeller centrifugal pump: a comparative study with the roller pump in open heart surgery
T Nishinaka1, H Nishida, M Endo
1Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
Insights
The Nikkiso Centrifugal Pump (NP) demonstrated reduced blood trauma during cardiopulmonary bypass (CPB) compared to roller pumps (RP). This centrifugal pump showed lower beta-thromboglobulin and plasma-free hemoglobin levels, indicating less damage to blood components.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Hematology
Background:
- Cardiopulmonary bypass (CPB) is essential for open-heart surgery but can cause blood trauma.
- Traditional roller pumps (RP) are associated with hemolysis and activation of blood components.
- Novel centrifugal pumps aim to minimize blood trauma during CPB.
Purpose of the Study:
- To evaluate the clinical performance of the Nikkiso Centrifugal Pump (NP), Model HPM15, during CPB.
- To compare the NP's effect on blood trauma markers with a conventional roller pump (RP).
- To assess hemodynamic performance and blood component integrity with the NP.
Main Methods:
- A prospective study involving 14 patients undergoing elective coronary artery bypass grafting using the Nikkiso Centrifugal Pump (NP).
- Blood samples were collected to measure serum hemoglobin, platelet count, serum beta-thromboglobulin (beta TG), and plasma-free hemoglobin levels.
- Results were compared with a historical control group (n=10) using a roller pump (RP).
Main Results:
- No significant difference in CPB duration between the NP (109 min) and RP (121 min) groups.
- Significantly lower serum beta TG levels in the NP group at 90 min of CPB.
- Significantly lower plasma-free hemoglobin levels in the NP group at multiple time points during and after CPB (p < 0.01).
- No significant difference in platelet depletion between the groups.
Conclusions:
- The Nikkiso Centrifugal Pump (HPM15) exhibits excellent hemodynamic performance in clinical CPB.
- The NP demonstrates reduced blood trauma, evidenced by lower beta TG and plasma-free hemoglobin levels, compared to roller pumps.
- The HPM15 centrifugal pump is a viable alternative for open-heart surgery, offering improved blood compatibility.
Abstract:
A centrifugal pump with an impeller (Nikkiso Centrifugal Pump, Model HPM15; Nikkiso Co. Ltd.) was applied to cardiopulmonary bypass (CPB) in 14 patients who underwent elective coronary artery bypass grafting. Serum hemoglobin level, platelet count, and serum beta-thromboglobulin (beta TG) level were measured during CPB. The results were compared with those obtained in a comparative roller pump (RP) group (n = 10). There was no difference in the time on CPB between the NP (109 min) and RP (121 min) groups. The serum beta TG level (ng/ml) was lower in the NP group than in the RP group (obtained 90 min after the initiation of CPB). The plasma-free hemoglobin level also was lower in the NP group than in the RP group (obtained 90 min after the initiation of CPB, 120 min after the initiation of CPB, immediately after the termination of CPB, 3 h after termination of CPB; p < 0.01). There was no significant difference in platelet depletion. The HPM15 pump showed excellent hemodynamic performance with less blood trauma compared with the roller pump in its clinical application to open heart surgery.