Thorac Cardiovasc Surg 2014; 62 - SC123
DOI: 10.1055/s-0034-1367384

Coronary artery revascularization with a minimized extracorporeal circulation system (MECC): The inflammatory response in comparison to conventional cardiopulmonary bypass

E. Srndic 1, A.H. Kiessling 1, F. Guo 1, H. Keller 2, A. Beiras-Fernandez 1, A. Moritz 1
  • 1Klinikum der Johann Wolfgang Goethe Universität Frankfurt aM, THG, Frankfurt am Main, Germany
  • 2Klinikum der Johann Wolfgang Goethe Universität Frankfurt aM, THG-Maquet Service, Frankfurt am Main, Germany

Objectives: Extracorporeal circulation can lead to a systemic inflammatory response (SIRS). Aim of the study was the evaluation of inflammatory markers in different cardiopulmonary bypass techniques..

Methods: In a prospective study, 72 patients (73 ± 5,3 years) were randomized in 3 subgroups: MECC (priming 550 ml, only cell saver suction), ECC (priming 1250 ml, CBP suction) and no-suction ECC (priming 1250 ml, cell saver suction). Evaluation of inflammatory parameters IL6, IL10, TNF-alpha and PNM elastase was performed preoperative (t1), 60 minutes after extracorporeal circulation start (t2), 4-6 h (t3), 24 h (t4) and 48 h postoperative (t5) and before discharge from hospital (t6).

Results: Patients were well comparable for all preoperative variables. Proinflammatory cytokines were significantly elevated by CPB during and after cardiac surgery procedures compared to t1. However, MECC or No-Suction ECC could not attenuate systemic inflammation derived by CPB. Operation time (MECC 261 ± 79 min; ECC 264 ± 75 min; No-suction ECC 231 ± 68 min) and perfusion time (MECC 115 ± 49 min; ECC 107 ± 37 min; No-suction ECC 99 ± 22 min) showed a faster performance trend in the no-suction-ECC group (p>0,05).

Conclusions: Neither the hemodilution and suction technique (MECC) nor the blood air interface (no-Suction ECC) could show benefits for the systemic inflammatory reaction induced by cardio-pulmonary bypass.