Clinical evaluation of minimized extracorporeal circulation in high-risk coronary revascularization: impact on air handling, inflammation, hemodilution and myocardial function

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dc.contributor.authorGünaydın, Serdar
dc.contributor.authorSarı Tamer
dc.contributor.authorMcCusker, Kevin
dc.contributor.authorSchonrock, Uwe
dc.contributor.authorZorlutuna, Yaman
dc.date.accessioned2020-06-25T17:48:28Z
dc.date.available2020-06-25T17:48:28Z
dc.date.issued2009
dc.departmentKırıkkale Üniversitesi
dc.description.abstractObjective: We examined intraoperative microembolic signals (GME), inflammatory response, hemolysis, perioperative regional cerebral oxygen saturation (rSO(2)), myocardial protection and desorbed protein amount on oxygenator fibers in high-risk patients undergoing coronary revascularization (CABG) with minimized and conventional cardiopulmonary bypass (CPB). Methods: Over a ten-month period, 40 Euroscore 6+ patients undergoing CABG were prospectively randomized to one of the two perfusion protocols (N=20): Group 1: minimized extracorporeal circuits (Mini-CPB) (ROCsafe MPC, Terumo, Ann Arbor, MI, USA) and Group 2: conventional extracorporeal circuits (CECC) (Capiox SX18, Terumo, USA). Serum creatinine kinase-MB (CKMB), free hemoglobin, interleukin-6 (IL-6) and C3a levels were measured. Blood samples were collected at T1: following induction of anesthesia; T2: thromboelastography control; T3: 15 min after commencement of CPB; T4: before cessation of CPB; T5: 15 min after protamine reversal and T6: ICU. Results: Serum IL-6 levels were significantly lower in the Mini-CPB group at T4 and T5 and C3a levels were significantly less in the Mini-CPB group at T3, T4 and T5 vs. CECC (p < 0.01). CKMB levels in coronary sinus blood demonstrated well preserved myocardium in the Mini-CPB group. Percentage expression of neutrophil CD11b/CD18 levels were significantly lower in the Mini-CPB group at T4 and T5 (p < 0.05). There were no significant differences in air handling characteristics or free plasma hemoglobin levels in either circuit. rSO(2) measurements were significantly better at T3 and T4 in the Mini-CPB vs. CECC (p < 0.05) and always higher in the Mini-CPB during follow-up. Blood protein adsorption analysis of oxygenator membranes demonstrated a significantly increased amount of microalbumin on CECC fibers (p < 0.05). Conclusion: Mini-CPB provided a comfort and safety level similar to conventional control via satisfactory air handling, attenuated inflammatory response and hemodilution, with a better clinical outcome in patients undergoing high-risk CABG.en_US
dc.identifier.citationclosedAccessen_US
dc.identifier.doi10.1177/0267659109346664
dc.identifier.endpage161en_US
dc.identifier.issn0267-6591
dc.identifier.issue3en_US
dc.identifier.pmid19755462
dc.identifier.scopus2-s2.0-70450188140
dc.identifier.scopusqualityQ1
dc.identifier.startpage153en_US
dc.identifier.urihttps://doi.org/10.1177/0267659109346664
dc.identifier.urihttps://hdl.handle.net/20.500.12587/4461
dc.identifier.volume24en_US
dc.identifier.wosWOS:000271848300002
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSage Publications Ltden_US
dc.relation.ispartofPerfusion-Uk
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCardiopulmonary bypassen_US
dc.subjectCPB-inflammatory responseen_US
dc.subjectminimal extracorporeal circulationen_US
dc.titleClinical evaluation of minimized extracorporeal circulation in high-risk coronary revascularization: impact on air handling, inflammation, hemodilution and myocardial functionen_US
dc.typeArticle

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