A new concept of integrated cardiopulmonary bypass circuit.

Details

Serval ID
serval:BIB_D332AD8D4BF5
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
A new concept of integrated cardiopulmonary bypass circuit.
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Mueller X.M., Jegger D., Augstburger M., Horisberger J., Godar G., von Segesser L.K.
ISSN
1010-7940
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
21
Number
5
Pages
840-846
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article - Publication Status: ppublish
Abstract
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.
Keywords
Animals, Blood Platelets, Cardiopulmonary Bypass, Cattle, Models, Animal, Oxygen, Pressure, Pulmonary Gas Exchange
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 10:28
Last modification date
20/08/2019 16:53
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