Outcomes comparison of 5 coated cardiopulmonary bypass circuits versus an uncoated control group of patients undergoing cardiac surgery

Marcoux, J.; Sohn, N.; McNair, Erick; Rosin, Mark W.; Smith, G; Lim, HJ; Mycyk, T; Meng, QH

doi:10.1177/0267659109352114

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Another study by Marcoux et al. investigating five different coated surfaces underscored that X‐coating CPB correlated with hs‐CRP levels similar to those after the uncoated CPB and that X‐coating failed to achieve shorter ventilation time or ICU length of stay compared with the uncoated circuits (23). The same study showed that X‐coating achieved the worst clinical results—when compared with the other four different coating technologies—in terms of transfusion requirements, intubation time, and ICU length of stay (23).…”

Section: Discussionmentioning

confidence: 97%

Clinical Evaluation of New Generation Oxygenators With Integrated Arterial Line Filters for Cardiopulmonary Bypass

Onorati¹,

Santini²,

Raffin³

et al. 2012

Artificial Organs

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New generation oxygenators with integrated arterial line filters have been marketed to improve the efficacy of cardiopulmonary bypass (CPB). Differences in designs, materials, coating surfaces, pore size of arterial filter, and static prime exist between the oxygenators. Despite abundant preclinical data, literature lacks clinical studies. From September 2010 to March 2011, 80 consecutive patients were randomized to CPB using Terumo Capiox FX25 (40 patients, Group-T) or Sorin Synthesis (40 patients, Group-S) oxygenators. Pressure drop and gas exchange efficacy were registered during CPB. High-sensitivity C-reactive protein (hs-CRP), white blood cells (WBCs), fluid balance, activated clotting time, international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, platelets (PLTs), serum albumin, and total proteins were measured perioperatively at different timepoints. Clinical outcome was recorded. Repeated measure analysis of variance and nonparametric statistics assessed between-groups and during time differences. The two groups showed similar baseline and intraoperative variables. No differences were recorded in pressure drop and gas exchange (group-P and group*time-P = N.S. for all) during CPB. Despite similar fluid balance (P = N.S. for static/dynamic priming and ΔVolume administered intraoperatively), Group-T showed higher hs-CRP (group-P = 0.034), aPTT (group-P = 0.0001), and INR (group-P= 0.05), with lower serum albumin (group-P = 0.014), total proteins (group-P = 0.0001), fibrinogen (group-P = 0.041), and PLTs (group-P = 0.021). Group-T also showed higher postoperative bleeding (group-P = 0.009) and need for transfusions (P = 0.008 for packed red cells and P = 0.0001 for fresh frozen plasma and total transfused volumes). However, clinical outcome was comparable (P = N.S. for all clinical endpoints). Both oxygenators proved effective and resulted in comparable clinical outcomes. However, Sorin Synthesis seems to reduce inflammation and better preserve the coagulative cascade and serum proteins, resulting in lower transfusions and post-CPB inflammatory response.

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Section: Discussionmentioning

confidence: 97%

Clinical Evaluation of New Generation Oxygenators With Integrated Arterial Line Filters for Cardiopulmonary Bypass

Onorati¹,

Santini²,

Raffin³

et al. 2012

Artificial Organs

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“…The use of PEO is commercially available as part of the Trillium package on Medtronic tubing. Studies using the Trillium surface have shown reductions in inflammatory markers and reduced bleeding events [38][39][40], but also increased stroke rates [38] from cardiopulmonary bypass. Like most CPB studies, these are small, single-center studies with variable sample collection, and no long-term studies have been performed.…”

Section: Polyethylene Oxide (Peo)mentioning

confidence: 99%

“…Like other coatings, PMEA-coated systems have improved markers of inflammation and some clinical outcomes over non-coated systems [44,45]. However, several studies have demonstrated increases in ventilator times, chest tube output, and inflammatory markers of PMEA compared to other coatings [39,46,47], while others studies found little or no difference between PMEA and heparin-coated surfaces [44,48].…”

Section: Poly 2-methoxyethylacrylatementioning

confidence: 99%

ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

Maul¹,

Massicotte²,

Wearden³

2016

Extracorporeal Membrane Oxygenation: Advances in Therapy

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The interaction between the patient and the ECMO (extracorporeal membrane oxygenation) circuit initiates a significant coagulation and inflammatory response due to the large surface area of foreign material contained within the circuit. This response can be blunted with the appropriate mix of biocompatible materials and anticoagulation therapy. The use of anticoagulants, in turn, requires appropriate laboratory testing to determine whether the patient is appropriately anticoagulated. Physicians must balance the risks of bleeding with the risks of thrombosis; the proper interpretation of these tests is often shrouded in mystery. It is the purpose of this chapter to help demystify the coagulation system, anticoagulants, biocompatible surfaces, and coagulation testing so that ECMO practitioners can make informed decisions about their patients and to spur coordinated efforts for future research to improve our understanding of these complex processes.

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“…Clinical outcomes are under investigation and, indeed, part of the study has been published recently. 3 More data of the impact of different coating CPB on renal function, bleeding, atrial fibrillation, neurofunction, and length of hospital stay will be released shortly.…”

mentioning

confidence: 99%

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Sohn¹,

Marcoux

Mycyk

et al. 2010

Perfusion

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Outcomes comparison of 5 coated cardiopulmonary bypass circuits versus an uncoated control group of patients undergoing cardiac surgery

Cited by 12 publications

References 24 publications

Clinical Evaluation of New Generation Oxygenators With Integrated Arterial Line Filters for Cardiopulmonary Bypass

Clinical Evaluation of New Generation Oxygenators With Integrated Arterial Line Filters for Cardiopulmonary Bypass

ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

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