Passaroni AC, Felicio ML, Campos NLKLD, Silva MADM, Yoshida WB. Hemolysis and Inflammatory Response to Extracorporeal Circulation during On-Pump CABG: Comparison between Roller and Centrifugal Pump Systems.
Braz J Cardiovasc Surg 2018;
33:64-71. [PMID:
29617504 PMCID:
PMC5873773 DOI:
10.21470/1678-9741-2017-0125]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/23/2017] [Indexed: 11/06/2022] Open
Abstract
Objective
To compare the perioperative incidence rates of hemolysis and inflammatory
response in patients undergoing coronary artery bypass grafting with the two
main types of cardiopulmonary bypass, centrifugal and roller pumps, and
establish correlations among hemolytic and inflammatory changes.
Methods
This was a prospective, randomized trial of 60 patients assigned to either
roller pump (G1, n=30) or centrifugal pump (G2, n=30) bypass. Markers of
hemolysis (serum haptoglobin, lactate dehydrogenase [LDH]) and
inflammation (interleukin [IL]1ß, IL-6, and
TNF-α) were measured and analyzed.
Results
There was no significant between-group difference in the variables of
interest. In G1, there was a positive association with IL-6 and TNF-α
(P<0.01 and P<0.05,
respectively). In G2, there was a positive association with LDH in the
postoperative period (P<0.5). At 24h
post-cardiopulmonary bypass, there were positive associations between LDH
and IL-1ß (P<0.05), LDH and TNF-α
(P<0.01), haptoglobin and TNF-α
(P<0.05), and LDH and TNF-α
(P<0.01) in G1, and between LDH and IL-6
(P<0.01), LDH and TNF-α
(P<0.01), and LDH and IL-6 (P<0.01)
in G2.
Conclusion
There were no significant between-group differences in markers of hemolysis
or inflammation. IL-6 and TNF-α were positively associated with
duration of cardiopulmonary bypass in G1, while LDH was positively
associated with duration of cardiopulmonary bypass in G2. The rate of
significant associations between markers of hemolysis and inflammation was
higher in the roller pump group (G1).
Registration number
ReBEC (RBR-92b9dg).
Collapse