Retrospective Comparison of the Effects of Centrifugal and Roller Pump Heads on the Hemostatic System During Open Heart Surgery

  • Hüseyin Demirtaş
  • Erkan İriz
  • Yiğit Kılıç
  • Dilek Erer
  • Gürsel Levent Oktar
  • Mustafa Arslan Gazi University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey

Abstract

Background and Aim: Technological developments and enhancement of knowledge level enable heart surgery with low mortality and morbidity rates in most centers. On the other hand, hemostasis management during cardiopulmonary bypass (CPB) plays a critical role in development of postoperative complications. We aimed to compare the effects of centrifugal pump and roller pump techniques on hemostatic system during CPB. Material and Methods: One hundred patients, who underwent coronary artery bypass surgery by the same surgical team with CPB pump using either roller or centrifugal pump, at Department of Cardiovascular Surgery of Gazi University between June 2012 and June 2013 were enrolled. Patients over 40 years old and without any known immunologic, infectious or inflammatory diseases and hematological problems for the last 6 months were included. Two study groups (Group R: Roller pump group and Group C: Centrifugal pump group) were created. Platelet counts, albumin levels were measured before and after CPB (pump); the amount of blood used during  CPB, total blood amount used, percentage of patients using five or more units of blood during CPB, percentage of patients who didn't receive fresh frozen plasma (FFP)or  apheresis platelet concentrates were recorded. Results:The amount of blood transfused during CPB was significantly lower in Group C than in Group R (0.28 ± 0.08 U; 0.68 ± 0.13) (p=0.010), while the total amount of blood transfused was significantly higher in Group R compared to Group C (p<0.0001). Preoperative and postoperative platelet levels were similar between groups, but platelet levels were significantly lower in both groups compared to their preoperative levels (Group C, p<0.0001, Group R, p<0.0001). When the preoperative albumin levels were compared, the patients in Group R had higher albumin levels than in Group C, whereas postoperative albumin levels were significantly higher in Group C than Group R (p<0.0001). The percentage of patients who didn't receive blood transfusion during CPB was significantly higher in Group C (p=0.011). While the percentage of patients who didn't receive FFP transfusion was significantly higher in Group C (p=0.002), the percentage of patients who didn't receive apheresis platelet transfusion was similar. Conclusion: Our findings indicate that usage of centrifugal pump has clear superiority in terms of effects on hemostatic system during CPB when compared to roller pump. Nevertheless, we believe that our results should be supported by advanced clinical and experimental studies.

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Published
2020-09-12
Section
Original Research