Blood product use during routine open heart surgery: the impact of the centrifugal pump.

A prospective randomized study was done including 1,000 patients undergoing routine open heart surgery. Patients were randomly assigned to either a roller pump or a BioMedicus centrifugal pump with identical extracorporeal circuits. There were no significant differences between study groups. Actual blood products transfused and predicted transfusion requirements (using Cardiac RiskMaster) were examined as was chest tube drainage (CTD). The predicted transfusion requirement was 885 of 1,000 patients. Transfusions were required by 472 of 1,000. Risk factors as significant predictors of increased CTD and use of blood products were emergency surgery status, increased cross-clamp time, and higher predicted risk of mortality. The only significant predictor of decreased CTD was the use of a centrifugal pump. Predictors of increased length of stay were myocardial infarction, preoperative urea, age, and massive transfusion. Data provide evidence that use of the centrifugal pump improves patient outcomes by decreasing CTD and decreasing the requirements for transfusion, which results in a shorter hospital stay.

[1]  G. Rau,et al.  Platelet Function and Hemolysis in Centrifugal Pumps: In Vitro Investigations , 1999, The International journal of artificial organs.

[2]  D. Sharpe,et al.  Haemolysis during cardiopulmonary bypass: an in vivo comparison of standard roller pumps, nonocclusive roller pumps and centrifugal pumps , 1999, Perfusion.

[3]  E. Gams,et al.  Centrifugal pumping during routine open heart surgery improves clinical outcome. , 1998, Artificial organs.

[4]  K. Watterson,et al.  Inflammatory mediators in adults undergoing cardiopulmonary bypass: comparison of centrifugal and roller pumps. , 1998, The Annals of thoracic surgery.

[5]  N. Tanaka,et al.  [Clinical effect of high-flow pulsatile cardiopulmonary bypass in coronary artery bypass grafting]. , 1997, Kyobu geka. The Japanese journal of thoracic surgery.

[6]  J. Perttilä,et al.  Comparison of the effects of centrifugal versus roller pump on the immune response in open-heart surgery , 1995, Perfusion.

[7]  J. Gold,et al.  Centrifugal Pumping: The Patient Outcome Benefits Following Coronary Artery Bypass Surgery , 1995, The Journal of ExtraCorporeal Technology.

[8]  W. Yasnoff,et al.  Effective Use Of Outcomes Data In Cardiovascular Surgery , 1994, Health Care Technology Policy I: The Role of Technology in the Cost of Health Care.

[9]  C. Yakut,et al.  Cardiopulmonary Bypass Using Centrifugal Pump , 1992 .

[10]  J. Driessen,et al.  Comparison of the standard roller pump and a pulsatile centrifugal pump for extracorporeal circulation during routine coronary artery bypass grafting , 1991, Perfusion.

[11]  G. Hafner,et al.  Routine extracorporeal circulation with a centrifugal or roller pump. , 1991, ASAIO transactions.

[12]  W. Prellwitz,et al.  In-vitro assessment of centrifugal pumps for ventricular assist. , 1990, Artificial organs.

[13]  F. Loop,et al.  Centrifugal Pumps in Clinical Practice , 1989 .

[14]  H. Harasaki,et al.  Hemolysis. A comparative study of four nonpulsatile pumps. , 1988, ASAIO transactions.

[15]  F H Edwards,et al.  Use of a Bayesian statistical model for risk assessment in coronary artery surgery. , 1988, The Annals of thoracic surgery.

[16]  S. Bhakdi,et al.  Deposition of terminal C5b-9 complement complexes on erythrocytes and leukocytes during cardiopulmonary bypass. , 1988, The New England journal of medicine.

[17]  K. Sakai,et al.  [A comparison of centrifugal and roller pumps. An experimental study]. , 1984, Kyobu geka. The Japanese journal of thoracic surgery.

[18]  A. Dobell,et al.  Catastrophic hemorrhage during redo sternotomy. , 1984, The Annals of thoracic surgery.

[19]  M F Lynch,et al.  Centrifugal blood pumping for open heart surgery. , 1978, Minnesota medicine.