A new concept of integrated cardiopulmonary bypass circuit.
Détails
ID Serval
serval:BIB_D332AD8D4BF5
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
A new concept of integrated cardiopulmonary bypass circuit.
Périodique
European Journal of Cardio-Thoracic Surgery
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
2002
Peer-reviewed
Oui
Volume
21
Numéro
5
Pages
840-846
Langue
anglais
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article - Publication Status: ppublish
Résumé
OBJECTIVE: Standard cardiopulmonary bypass (CPB) circuits with their large surface area and volume contribute to postoperative systemic inflammatory reaction and hemodilution. In order to minimize these problems a new approach has been developed resulting in a single disposable, compact arterio-venous loop, which has integral kinetic-assist pumping, oxygenating, air removal, and gross filtration capabilities (CardioVention Inc., Santa Clara, CA, USA). The impact of this system on gas exchange capacity, blood elements and hemolysis is compared to that of a conventional circuit in a model of prolonged perfusion. METHODS: Twelve calves (mean body weight: 72.2+/-3.7 kg) were placed on cardiopulmonary bypass for 6 h with a flow of 5 l/min, and randomly assigned to the CardioVention system (n=6) or a standard CPB circuit (n=6). A standard battery of blood samples was taken before bypass and throughout bypass. Analysis of variance was used for comparison. RESULTS: The hematocrit remained stable throughout the experiment in the CardioVention group, whereas it dropped in the standard group in the early phase of perfusion. When normalized for prebypass values, both profiles differed significantly (P<0.01). Both O2 and CO2 transfers were significantly improved in the CardioVention group (P=0.04 and P<0.001, respectively). There was a slightly higher pressure drop in the CardioVention group but no single value exceeded 112 mmHg. No hemolysis could be detected in either group with all free plasma Hb values below 15 mg/l. Thrombocyte count, when corrected by hematocrit and normalized by prebypass values, exhibited an increased drop in the standard group (P=0.03). CONCLUSION: The CardioVention system with its concept of limited priming volume and exposed foreign surface area, improves gas exchange probably because of the absence of detectable hemodilution, and appears to limit the decrease in the thrombocyte count which may be ascribed to the reduced surface. Despite the volume and surface constraints, no hemolysis could be detected throughout the 6 h full-flow perfusion period.
Mots-clé
Animals, Blood Platelets, Cardiopulmonary Bypass, Cattle, Models, Animal, Oxygen, Pressure, Pulmonary Gas Exchange
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2008 9:28
Dernière modification de la notice
20/08/2019 15:53