Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598736
Oral Presentations
Sunday, February 12, 2017
DGTHG: ECC and Myocardial Protection
Georg Thieme Verlag KG Stuttgart · New York

Minimal Invasive Extracorporeal Circulation (MIECC) and the Role of Shed Blood Separation on the Inflammation-Process after CABG Surgery

A. Bauer
1   MediClin Herzzentrum Coswig, Clinical Perfusion, Coswig, Germany
,
H. Nygaard
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
P. Johansen
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
D. Troitzsch
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
T. Eberle
3   Anästhesiology, MediClin Herzzentrum Coswig, Coswig, Germany
,
H. Hausmann
4   Cardiothoracic and Vascular Surgery, MediClin Herzzentrum Coswig, Coswig, Germany
,
J.M. Hasenkam
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

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Objectives: Cardiopulmonary bypass (CPB) triggers a systemic inflammatory response syndrome (SIRS) largely caused by the contact of blood with foreign surfaces and by recirculation of activated shed mediastinal blood, a main cause of blood cell activation and cytokine release. Minimal invasive Extracorporeal Circulation (MiECC) comprises a completely closed (no blood-air contact) circuit, coated surfaces (biocompatible treatment) and the separation of suction blood. All three aspects have the potential to reduce this activation. This study investigates the impact of washed or unwashed shed blood on initiating of inflammatory processes.

Hypothesis: The separation and cell savage of shed blood during MiECC procedures reduces inflammatory response compared with MiECC with direct retransfusion. Mean difference for tumor necrosis factor-α (TNF-α) as marker for SIRS is reduced by at least 7.5 ng/L in the cell savage group 10 minutes after CPB.

Methods: All patients receive MiECC. All aspects of the surgical procedures and CPB remain completely identical. Patients are divided into two groups, a direct re-transfusion (DRT, control group) receiving untreated blood and a cell salvage (CS, study group) receiving washed blood.

Results: A total of 70 patients were investigated. No differences in the preoperative characteristics of the patients were apparent except patients suffering from diabetes were more present in the DRT group 17 (47%) versus 6 (20%), p = 0.037 in the CS group. There was a significant rise in TNF-α in the group without cell savage 10 minutes after ECC, 9.5 ± 3.5 versus 19.7 ± 14.5, p < 0.000. Six hours after ECC the difference was still significant, 11.5 ± 11.0 versus 17.4 ± 8.54, p = 0.02.

Conclusion: The results of this study support the theory that cell savage might reduce inflammatory response after CABG-surgery. But the issue of the influence of shed blood separation on these results should be discussed more intensive.