Haemolysis during cardiopulmonary bypass: an in vivo comparison of standard roller pumps, nonocclusive roller pumps and centrifugal pumps

Autor:	C M Munsch, K R Welsh, D A Sharpe, R Catchpole, P H Kay, J P McGoldrick, S D Hansbro
Rok vydání:	1999
Předmět:	Male medicine.medical_specialty animal structures Peristaltic pump Heart-Lung Machine 030204 cardiovascular system & hematology Hematocrit Hemolysis law.invention Hemoglobins Intraoperative Period Leukocyte Count 03 medical and health sciences 0302 clinical medicine law In vivo Internal medicine Occlusion Cardiopulmonary bypass Humans Medicine Radiology Nuclear Medicine and imaging Coronary Artery Bypass Aged Advanced and Specialized Nursing medicine.diagnostic_test Platelet Count business.industry Equipment Design General Medicine Middle Aged Haemolysis Centrifugal pump Surgery 030228 respiratory system Erythrocyte Count Cardiology Female Cardiology and Cardiovascular Medicine business Safety Research
Zdroj:	Perfusion. 14:3-10
ISSN:	1477-111X 0267-6591
DOI:	10.1177/026765919901400102
Popis:	Cardiopulmonary bypass (CPB) involves the use of either an occlusive roller pump or centrifugal pump. Damage to blood elements, including haemolysis, may arise from occlusion when using a roller pump; the appropriate degree of occlusion has not yet been determined scientifically. Centrifugal and nonocclusive roller pumps are reputed to reduce haemolysis. The objective of this study was to compare haemolysis caused by a standard roller pump with a dynamically set nonocclusive roller pump and with a centrifugal pump. We prospectively randomized 60 patients undergoing routine coronary artery surgery into three groups: standard roller pump (STD, n = 20), dynamically set roller pump (DYN, n = 20), or centrifugal pump (CEN, n = 20). The level of plasma free haemoglobin (FHb) was measured preoperatively, and the rate of formation of FHb (in mg/dl/min) was determined at the end of the ischaemic phase and at the end of CPB. Cardiotomy suction blood was isolated for the ischaemic phase and returned before the end of CPB. It was found that there were no differences between the groups in demographic or operative variables. The rate of formation of FHb at the end of the ischaemic phase was similar for all groups (STD 0.108 ± 0.10, DYN 0.117 ± 0.08, CEN 0.129 ± 0.07). At the end of CPB, after return of the cardiotomy suction blood, there was a significant ( We conclude that the rates of haemolysis are similar for each of the pump types, and no benefit is conferred by the use of either a dynamically set roller pump or a centrifugal pump compared with the standard roller pump. The return of the cardiotomy suction blood to the circulation is the principal source of plasma free haemoglobin.
Databáze:	OpenAIRE
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