Abstract
BackgroundElevated plasma free hemoglobin is associated with multi-organ injury. In this context, minimally invasive extracorporeal technologies represent a way to reduce this complication following cardiac surgery.MethodsWe present a pilot study focused on plasma free hemoglobin levels in 40 patients undergoing isolated coronary artery bypass grafting (CABG). The same circuits for minimally invasive extracorporeal circulation (MiECC) were used in all patients. The ECMOLIFE magnetic levitation pump was used in the study group (n = 20), and the AP40 Affinity CP centrifugal blood pump was used in the control group (n = 20).ResultsIn the immediate postoperative period, plasma free hemoglobin (PFH) and lactate dehydrogenase (LDH) were significantly lower in the study group than in the control group (10.6 ± 0.7 vs 19.9 ± 0.3 mg/dL, p = 0.034; and 99.16 ± 1.7 vs 139.17 ± 1.5 IU/L, p = 0.027, respectively). Moreover, patients treated with the magnetic levitation pump showed lower creatinine and indirect bilirubin (0.92 vs 1.29 mg/dL, p = 0.030 and 0.6 ± 0.4 vs 1.5 ± 0.9 mg/dL, p = 0.022, respectively) at 24 h after the procedure, and received fewer transfusions during the whole postoperative period (3 vs 9 red blood cell units (RBC), p = 0.017).ConclusionOur pilot study suggests that the use of magnetically levitated centrifugal pumps for extracorporeal circulation support is associated with a lower risk of hemolysis, though larger studies are warranted to confirm our results.
Highlights
Minimizing the risk of blood damage using minimally invasive extracorporeal technologies is critical, especially if patients show higher hematocritCondello et al J Cardiothorac Surg (2021) 16:253 and/or excess negative pressures within the circuit and blood transfusions [1, 2]
Elevated plasma free hemoglobin is associated with multi-organ injury, including severe acute kidney injury [3]
We present a pilot study on two different pump technologies, a magnetic levitation pump vs a constrained vortex pump, comparing 40 patients undergoing isolated coronary artery bypass grafting (CABG) using a minimally invasive extracorporeal circulation (MiECC) type IV system, which enables volume management
Summary
Minimizing the risk of blood damage (i.e. hemolysis) using minimally invasive extracorporeal technologies is critical, especially if patients show higher hematocritCondello et al J Cardiothorac Surg (2021) 16:253 and/or excess negative pressures within the circuit and blood transfusions [1, 2]. Minimizing the risk of blood damage (i.e. hemolysis) using minimally invasive extracorporeal technologies is critical, especially if patients show higher hematocrit. Elevated plasma free hemoglobin is associated with multi-organ injury, including severe acute kidney injury [3]. In this context, we present a pilot study on two different pump technologies, a magnetic levitation pump vs a constrained vortex pump, comparing 40 patients undergoing isolated coronary artery bypass grafting (CABG) using a minimally invasive extracorporeal circulation (MiECC) type IV system, which enables volume management. Elevated plasma free hemoglobin is associated with multi-organ injury. In this context, minimally invasive extracorporeal technologies represent a way to reduce this complication following cardiac surgery
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