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Clinical evaluation of the centrifugal pump in open heart surgery: a comparative study of different pumps
K Takarabe1, M Yoshikai, J Murayama
1Department of Cardiovascular Surgery, Koga Hospital, Kurume, Japan.
Insights
This study compared four centrifugal pumps used in open heart surgery. While the HPM-15 pump showed a greater decrease in platelet count, all four centrifugal pumps were found to be safe for clinical use.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Hematology
Background:
- Centrifugal pumps are integral to open heart surgery, offering benefits to blood elements and coagulation.
- Understanding the comparative impact of different centrifugal pump models is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the clinical performance and outcomes of four distinct centrifugal pump types.
- To investigate the effects of these pumps on blood elements, coagulation, complements, and immunoglobulins during cardiopulmonary bypass.
Main Methods:
- Four centrifugal pumps were evaluated: HPM-15, Capiox, Lifestream, and BP-80.
- Key parameters measured included platelet count, lactate dehydrogenase (LDH), antithrombin III (AT III), thrombin-antithrombin complex (TAT), complements (C3, C4, CH50), and immunoglobulins (IgG, IgA, IgM).
- Measurements were taken pre- and post-cardiopulmonary bypass (CPB).
Main Results:
- A statistically significant decrease in platelet count was observed with the HPM-15 pump compared to the others.
- No significant differences were found among the four pumps regarding LDH, AT III, TAT, complements, or immunoglobulins.
- All tested centrifugal pumps demonstrated safety during clinical application.
Conclusions:
- While the HPM-15 pump may have a more pronounced effect on platelet count, all four centrifugal pumps evaluated are clinically safe for use in open heart surgery.
- Further research may explore strategies to mitigate platelet reduction associated with specific pump designs.
Abstract:
The centrifugal pump is now widely used in open heart surgery for its clinical benefits related to the blood elements and the coagulation system. The purpose of this study was to compare the clinical performances of and the outcomes offered by 4 types of centrifugal pumps. For each pump, we investigated the effects on the blood elements, coagulation system, complements, and immunoglobulins during open heart surgery. Four types of centrifugal pumps were used: the HPM-15 (Nikkiso Co.), the Capiox (Terumo Co.), the Lifestream (St. Jude Medical Co.), and the BP-80 (Medtronic, BioMedicus Co.). The platelet count, lactate dehydrogenase (LDH), antithrombin III (AT III), thrombin-antithrombin complex (TAT), complements (C3, C4, and CH50), and immunoglobulins (IgG, IgA, and IgM) were measured before and after cardiopulmonary bypass (CPB). The platelet count was decreased more significantly by the HPM-15 than by any of the other pumps. The other parameters showed no difference among the 4 pumps. In clinical use, each of the 4 types of centrifugal pumps was safe.