Abstract
Commentary: Miniaturized extracorporeal circulation, the “circuit-of-choice?”
Highlights
Cardiopulmonary bypass (CPB), a prerequisite for major cardiac surgery, inevitably accompanies hemodilution and systemic inflammatory response syndrome that may contribute to impairments in the O2-carrying capacity, increased transfusion requirements, and multiorgan dysfunction, leading to increased risks of morbidity and mortality.[1]
The use of Miniaturized extracorporeal circulation (MECC) has been still limited in clinical practice, with only 4% to 10% of operations using MECC.[5]
The analysis demonstrates significant superiority of MECC in reducing the composite incidence of postoperative mortality, stroke, renal failure, and myocardial infarction over conventional extracorporeal circulation (CECC)
Summary
Cardiopulmonary bypass (CPB), a prerequisite for major cardiac surgery, inevitably accompanies hemodilution and systemic inflammatory response syndrome that may contribute to impairments in the O2-carrying capacity, increased transfusion requirements, and multiorgan dysfunction, leading to increased risks of morbidity and mortality.[1]. Miniaturized extracorporeal circulation (MECC) has been developed to minimize the drawbacks of CPB by attenuating systemic inflammatory response syndrome via limiting the blood–air interface and reducing the artificial tubing length with the renunciation of cardiotomy suction and a venous reservoir.[2] Most previous clinical studies, including several meta-analyses, have shown the potential benefits of MECC over conventional extracorporeal circulation (CECC)[3,4]; these studies have failed to demonstrate overt benefits in terms of clinically relevant hard end points and were not supported by subsequent large-scale studies.
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