Clinical comparison oftwo types of cardiopulmonary bypass: open circuit versus close circuit applicationin coronary surgical patients
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Abstract
Purpose: Comparative study of 2 techniques of cardiopulmonary bypass (CPB):
- Technique of open circuit without treatment of blood aspirated from surgical field;
- Technique of close circuit with treatment of air – blood surface reduction and blood aspirated from surgical field.
Method: This was a clinical prospective, randomized, comparative study in application of open circuit and close circuittechniques in cardiopulmonary bypass in 30 patients undergoing coronary artery bypass graft dividing in 2 groups:
- Conventional open circuit group (n = 15);
- Modified close circuit group (n = 15).
Results:
- There were not significantly the differences between open circuit and close circuit groups in patient‟s age (65±8 vs 66±9 years old); male / female (14/1 vs 14/1); pre-op hematocrit (38,8±2,7 vs 38,6±2,8 %).
- The parameters in CPB technique and surgical intervention of 2 groups were moderately similar in aortic clamp duration (52±15 vs45±14 min); CPB duration (90±28 vs 74±23 min); surgery duration(295±45 vs 268±35 min); and numbers of CABG (2,5±0,6 vs 2,2±0,4 grafts).
- There were significantly differences in transfusion (0,9±1,8 vs 0,4±0,8 units, p<0,01); improved inflammatory response after CPB with reduction of serum substances such as PS100 (0,7±1,2 vs 2,4±1,8 mcg/L, p<0,001); CRP (173,1±65,5 vs 189,1±60,3 mg/L, p<0,001); C3a (1356±634 vs 1785±1000 ŋg/L, p<0,001); and IL-6 (498±864 vs 243±167 mcg/L, p<0,001).
- There were significantly differences in clinical outcomes of 2 groups in ventilation duration (5,9±2,0 vs 5,2±1,2; p<0,01); ICU time (66±35 vsi 57±30, p<0,009); and period of hospitalization (10±3 vs 8±2, p<0,0009).
Conclusion: In comparison with the CPB open circuit technique, the CPB close circuit technique applied with the aim to reduce the inflammatory response and its consequence, and then enable us to improve on quality of treatment in CABG patients such as reduction of ventilation duration, ICU time and period of hospitalization.
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References
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