Abstract
Cardiopulmonary bypass is associated with hemodilution and contact activation through the surface of the tubing system. Both may contribute to blood loss and perioperative transfusion requirements. When the extracorporeal circuit is adapted from an open to a closed system, and tubing has biocompatible coating, there is less hemostatic activation. Moreover, retrograde and antegrade autologous priming reduce the impact of hemodilution. All three modalities may contribute to less transfusion requirements, and should be considered as part of a patient blood management program.
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References
Hou X, Yang F, Liu R, et al. Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion in small adults: a prospective, randomized trial. Eur J Anaesthesiol. 2009;26:1061–6.
Nakahira A, Sasaki Y, Hirai H, et al. Closed cardiopulmonary bypass circuits suppress thrombin generation during coronary artery bypass grafting. Interact Cardiovasc Thorac Surg. 2010;10:555–60.
Lindholm L, Westerberg M, Bengtsson A, Ekroth R, Jensen E, Jeppsson A. A closed perfusion system with heparin coating and centrifugal pump improves cardiopulmonary bypass biocompatibility in elderly patients. Ann Thorac Surg. 2004;78:2131–8.
Nakahira A, Sasaki Y, Hirai H, et al. Cardiotomy suction, but not open venous reservoirs, activates coagulofibrinolysis in coronary artery surgery. J Thorac Cardiovasc Surg. 2011;141:1289–97.
Casalino S, Stelian E, Novelli E, et al. Reduced transfusion requirements with a closed cardiopulmonary bypass system. J Thorac Cardiovasc Surg. 2008;49:363–9.
Potger KC, McMillan D, Ambrose M. Microbubble transmission during cardiotomy infusion of a hardshell venous reservoir with integrated cardiotomy versus a softshell venous reservoir with separated cardiotomy: an in vitro comparison. J Extra Corpor Technol. 2013;45:77–85.
Murphy GS, Hessel EA 2nd, Groom RC. Optimal perfusion during cardiopulmonary bypass: an evidence-based approach. Anesth Analg. 2009;108:1394–417.
Tanaka H, Oshiyama T, Narisawa T, et al. Clinical study of biocompatibility between open and closed heparin-coated cardiopulmonary bypass circuits. J Artif Organs. 2003;6:245–52.
Ranucci M, Balduini A, Ditta A, Boncilli A, Brozzi S. A systematic review of biocompatible cardiopulmonary bypass circuits and clinical outcome. Ann Thorac Surg. 2009;87:1311–9.
Mahmood S, Bilal H, Zaman M, Tang A. Is a fully heparin-bonded cardiopulmonary bypass circuit superior to a standard cardiopulmonary bypass circuit? Interact Cardiovasc Thorac Surg. 2012;14:406–14.
Landis RC, Brown JR, Fitzgerald D, et al. Attenuating the systemic inflammatory response to adult cardiopulmonary bypass: a critical review of the evidence base. J Extra Corpor Technol. 2014;46:197–211.
Paparella D, Scrascia G, Rotunno C, et al. A biocompatible cardiopulmonary bypass strategy to reduce hemostatic and inflammatory alterations: a randomized controlled trial. J Cardiothorac Vasc Anesth. 2012;26:557–62.
Lorusso R, de Cicco G, Totaro P, Gelsomino S. Effects of phosphorylcholine coating on extracorporeal circulation management and postoperative outcome: a double-blind randomized study. Interact Cardiovasc Thorac Surg. 2009;8:7–11.
Marguerite S, Levy F, Quessard A, Dupeyron JP, Gros C, Steib A. Impact of a phosphorylcholine-coated cardiac bypass circuit on blood loss and platelet function: a prospective, randomized study. J Extra Corpor Technol. 2012;44:5–9.
Hosoyama K, Ito K, Kawamoto S, et al. Poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit can reduce transfusion of platelet products compared to heparin-coated circuit during aortic arch surgery. J Artif Organs. 2016;19:233–40.
Thiara AS, Mollnes TE, Videm V, et al. Biocompatibility and pathways of initial complement pathway activation with Phisio- and PMEA-coated cardiopulmonary bypass circuits during open-heart surgery. Perfusion. 2011;26:107–14.
Wahba A, Philipp A, Behr R, Birnbaum DE. Heparin-coated equipment reduces the risk of oxygenator failure. Ann Thorac Surg. 1998;65:1310–2.
Sun P, Ji B, Sun Y, et al. Effects of retrograde autologous priming on blood transfusion and clinical outcomes in adults: a meta-analysis. Perfusion. 2013;28:238–43.
Saczkowski R, Bernier PL, Tchervenkov CI, Arellano R. Retrograde autologous priming and allogeneic blood transfusions: a meta-analysis. Interact Cardiovasc Thorac Surg. 2009;8:373–6.
Vandewiele K, Bove T, de Somer FM, et al. The effect of retrograde autologous priming volume on haemodilution and transfusion requirements during cardiac surgery. Interact Cardiovasc Thorac Surg. 2013;16:778–83.
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Wahba, A. (2019). Cardiopulmonary Bypass. In: von Heymann, C., Boer, C. (eds) Patient Blood Management in Cardiac Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-15342-7_13
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DOI: https://doi.org/10.1007/978-3-030-15342-7_13
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