Heparin-Bonded Cardiopulmonary Bypass Circuits Reduce the Rate of Red Blood Cell Transfusion During Elective Coronary Artery Bypass Surgery

Kreisler, Kenneth R.; Vance, Robert A.; Cruzzavala, Jose; Mahnken, Jonathan D.

doi:10.1053/j.jvca.2005.07.003

Cited by 14 publications

(8 citation statements)

References 15 publications

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“…Method used to conceal treatment allocation was not described. [German language]Participants18 patients undergoing orthotopic liver transplantation were randomised to one of two groups: Aprotinin group: n = 9, mean age 47.9 yearsControl group (Placebo): n = 9, mean age 49.4 years NB: Gender data were not reported.Interventions Aprotinin group received an intravenous bolus of 2 million KIU (280mg) of aprotinin at induction of anaesthesia and a continuous infusion of 500,000 KIU/hr of aprotinin until the end of the operation.Control group received physiological saline solution. Outcomes Outcomes reported: Allogeneic blood usage (units), coagulation parameters, blood lossNotesTransfusion protocol used Risk of bias Item Authors’ judgement Description Adequate sequence generation?UnclearUnclearAllocation concealment?UnclearUnclearBlinding?All outcomesUnclearUnclear Kreisler 2005…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

Henry

Carless

Moxey

et al. 2011

Cochrane Database of Systematic Reviews

535

440

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Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

Henry

Carless

Moxey

et al. 2011

Cochrane Database of Systematic Reviews

535

440

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“…5 Later, it was proven to have biocompatibility properties as well by inhibiting contact and complement activation and adsorbing lipoproteins, simulating the behaviour of cell membranes. 6,7 Many trials show that heparin-coated circuits reduce postoperative blood loss and the need for red blood cell transfusion, 3 and ventilation time and ICU stay. 8 One meta-analysis with 3434 patients in 41 original randomized papers shows that heparin-coated circuits decrease blood loss and red blood cell transfusion by 20%, re-sternotomy by 40%, ventilation by 78 minutes, average ICU stay by 9.3 hours and hospital stay by 0.5 days when compared to non-heparin-bonded circuits.…”

Section: Discussionmentioning

confidence: 99%

“…These systems have been shown to provide better hemocompatibility with less platelet activation and reduced inflammatory response with less white blood cell adhesions. As a result, less postoperative bleeding and a decreased need of red blood cell transfusion 3 has been reported. Conflicting results are reported with regard to postoperative outcomes following the usage of coated perfusion circuits.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of outcome data with regards to the use of Phisio®-, Bioline®- or Softline®-coated cardiopulmonary bypass circuits in cardiac surgery

et al. 2012

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BACKGROUND: Numerous cardiopulmonary bypass circuits with various coatings designed to reduce the inflammatory response and to provide better hemocompatibility are available. The aim of this study was to compare the effect of phosphorylcholine-coated, albumin-heparin-coated and synthetic polymer-coated perfusion tubing systems on patient outcome. METHODS: We performed a retrospective database review of elective patients between January 1st 2010 and December 31st 2010. Demographics, preoperative, operative, postoperative data and follow-up were collected and statistically analysed. RE-SULTS: We identified 201 patients and formed three groups: Group 1 with phosphorylcholine coating (n=133), Group 2 with albumin-heparin coating (n=32) and Group 3 synthetic polymer coating (n=36). Mean age was 68±11years, additive Euroscore 5.8±2.7. In-hospital outcomes were comparable between the groups without statistically significant differences. The overall 30-day and 1-year late survival were 98.5% and 96.7±1.9%, respectively. CONCLUSIONS: Our findings suggest that in-hospital and followup outcomes are comparable in cardiac surgery patients after using either phosphorylcholine-coated, albumin-heparin-coated or synthetic polymer-coated circuits during cardiopulmonary bypass.

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“…In this study, we focused on the circuits used during cardiopulmonary bypass (CPB), where examples of some of the major complications are massive complement activation and inflammation and postoperative haemorrhage. The use of heparin coating in circuits has been reported independently to reduce both of these problems . Hence, the Bioline® circuit uses an albumin‐heparin coating in order to reduce postoperative blood loss .…”

Section: Introductionmentioning

confidence: 99%

“…The use of heparin coating in circuits has been reported independently to reduce both of these problems . Hence, the Bioline® circuit uses an albumin‐heparin coating in order to reduce postoperative blood loss . Phisio® coating is produced to mimic the properties of living cells and is comprised of phosphorylcholine polymer, which has demonstrated reduced protein adsorption .…”

Section: Introductionmentioning

confidence: 99%

Heparin-coated cardiopulmonary bypass circuits selectively deplete the pattern recognition molecule ficolin-2 of the lectin complement pathway in vivo

Hein

Munthe-Fog

Thiara

et al. 2015

Clinical and Experimental Immunology

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SummaryThe complement system can be activated via the lectin pathway by the recognition molecules mannose-binding lectin (MBL) and the ficolins. Ficolin-2 exhibits binding against a broad range of ligands, including biomaterials in vitro, and low ficolin-2 levels are associated with increased risk of infections. Thus, we investigated the biocompatibility of the recognition molecules of the lectin pathway in two different types of cardiopulmonary bypass circuits. Bloods were drawn at five time-points before, during and postoperatively from 30 patients undergoing elective cardiac surgery. Patients were randomized into two groups using different coatings of cardiopulmonary bypass circuits, Phisio® (phosphorylcholine polymer coating) and Bioline® (albumin-heparin coating). Concentrations of MBL, ficolin-1, −2 and −3 and soluble C3a and terminal complement complex (TCC) in plasma samples were measured. Ficolin-3-mediated complement activation potential was evaluated with C4, C3 and TCC as output. There was no significant difference between the two circuit materials regarding MBL, ficolin-1 and −3. In the Bioline® group the ficolin-2 levels decreased significantly after initiation of surgery (P < 0·0001) and remained reduced throughout the sampling period. This was not seen for Phisio®-coated circuits. Ficolin-3-mediated complement activation potential was reduced significantly in both groups after start of operation (P < 0·0001), whereas soluble C3a and TCC in the samples were increased (P < 0·0001). Ficolin-2 was depleted from plasma during cardiac surgery when using heparin-coated bypass circuits and did not reach baseline level 24 h postoperation. These findings may have implications for the postoperative susceptibility to infections in patients undergoing extracorporeal circulation procedures.

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Heparin-Bonded Cardiopulmonary Bypass Circuits Reduce the Rate of Red Blood Cell Transfusion During Elective Coronary Artery Bypass Surgery

Cited by 14 publications

References 15 publications

Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion

Retrospective analysis of outcome data with regards to the use of Phisio®-, Bioline®- or Softline®-coated cardiopulmonary bypass circuits in cardiac surgery

Heparin-coated cardiopulmonary bypass circuits selectively deplete the pattern recognition molecule ficolin-2 of the lectin complement pathway in vivo

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