The inflammatory response between miniaturised and conventional cardiopulmonary bypass after cardiac surgery in an Asian population

Perfusion. 2015 Sep;30(6):487-94. doi: 10.1177/0267659114563779. Epub 2014 Dec 11.

Abstract

Introduction: We compared the systemic inflammatory response of the MCPB system to the CCPB system with cell salvage and phosphorylcholine-coated tubing amongst Asian patients undergoing coronary artery bypass grafting.

Methods: Seventy-eight patients were randomly assigned to the MCPB or the CCPB groups equally and followed up in a prospective, single-blinded, randomised, controlled trial. Levels of TNF-α, IL-6, CRP and LDH were measured peri-operatively.

Results: The systemic inflammatory response was similar in both groups (TNF-α: p=0.222; IL-6: p=0.991; CRP: p=0.258). Only haemolysis was significantly higher in the CCPB group (LDH: p=0.011). The MCPB system was twice more expensive, but had a near 4-fold cost saving in tranfusions. Overall, the MCPB system cost 20% more than the modified CCPB system.

Conclusion: These results corroborate with studies that demonstrated the avoidance of cardiotomy suction rather than the MCPB system, itself, leads to an attenuated inflammatory response. The absence of obvious clinical benefit and the higher costs involved with the MCPB system would preclude its routine use.

Keywords: cardiopulmonary bypass; coronary artery bypass grafting; cost analysis; haemolysis; inflammation; miniaturised.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People
  • C-Reactive Protein / metabolism*
  • Cardiopulmonary Bypass / adverse effects*
  • Female
  • Humans
  • Interleukin-6 / blood*
  • L-Lactate Dehydrogenase / blood*
  • Male
  • Middle Aged
  • Postoperative Complications / blood*
  • Systemic Inflammatory Response Syndrome / blood*
  • Systemic Inflammatory Response Syndrome / etiology
  • Tumor Necrosis Factor-alpha / blood*

Substances

  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • L-Lactate Dehydrogenase