Abstract
Purpose of review To address the role of mini-cardiopulmonary bypass systems in cardiac operations, with specific respect to clinical outcome. Recent findings Mini-cardiopulmonary bypass systems are not accompanied by major complications, even if some safety concerns have been raised. Randomized controlled trials and large retrospective trials suggest that they can induce a beneficial effect in terms of morbidity reduction, shortening of mechanical ventilation time, ICU, and hospital stay, whereas mortality seems not to be affected. Studies failing to demonstrate significant differences were generally underpowered. A meta-analysis focused on allogeneic blood products transfusion rate demonstrates that mini-cardiopulmonary bypass systems reduce the transfusion rate (odds ratio 0.4, 95% confidence interval 0.26-0.63, P<0.001). This may be because of containment in hemodilution during cardiopulmonary bypass. The better outcome may be related to both this mechanism and the consequent reduction in transfusional needs. Summary Mini-cardiopulmonary bypass systems reduce the need for allogeneic blood transfusions. Other improvements in postoperative outcome are more debated. They require a long learning curve and are more expensive. A cost analysis based on a large randomized controlled trial is still needed to clarify the potential future role of these systems in clinical practice.
| Original language | English |
|---|---|
| Pages (from-to) | 78-83 |
| Number of pages | 6 |
| Journal | Current Opinion in Anaesthesiology |
| Volume | 22 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2009 |
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Keywords
- Cardiac surgery
- Cardiopulmonary bypass
- Transfusions
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Management of mini-cardiopulmonary bypass devices : Is it worth the energy? / Ranucci, Marco; Castelvecchio, Serenella.
In: Current Opinion in Anaesthesiology, Vol. 22, No. 1, 02.2009, p. 78-83.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Management of mini-cardiopulmonary bypass devices
T2 - Is it worth the energy?
AU - Ranucci, Marco
AU - Castelvecchio, Serenella
PY - 2009/2
Y1 - 2009/2
N2 - Purpose of review To address the role of mini-cardiopulmonary bypass systems in cardiac operations, with specific respect to clinical outcome. Recent findings Mini-cardiopulmonary bypass systems are not accompanied by major complications, even if some safety concerns have been raised. Randomized controlled trials and large retrospective trials suggest that they can induce a beneficial effect in terms of morbidity reduction, shortening of mechanical ventilation time, ICU, and hospital stay, whereas mortality seems not to be affected. Studies failing to demonstrate significant differences were generally underpowered. A meta-analysis focused on allogeneic blood products transfusion rate demonstrates that mini-cardiopulmonary bypass systems reduce the transfusion rate (odds ratio 0.4, 95% confidence interval 0.26-0.63, P<0.001). This may be because of containment in hemodilution during cardiopulmonary bypass. The better outcome may be related to both this mechanism and the consequent reduction in transfusional needs. Summary Mini-cardiopulmonary bypass systems reduce the need for allogeneic blood transfusions. Other improvements in postoperative outcome are more debated. They require a long learning curve and are more expensive. A cost analysis based on a large randomized controlled trial is still needed to clarify the potential future role of these systems in clinical practice.
AB - Purpose of review To address the role of mini-cardiopulmonary bypass systems in cardiac operations, with specific respect to clinical outcome. Recent findings Mini-cardiopulmonary bypass systems are not accompanied by major complications, even if some safety concerns have been raised. Randomized controlled trials and large retrospective trials suggest that they can induce a beneficial effect in terms of morbidity reduction, shortening of mechanical ventilation time, ICU, and hospital stay, whereas mortality seems not to be affected. Studies failing to demonstrate significant differences were generally underpowered. A meta-analysis focused on allogeneic blood products transfusion rate demonstrates that mini-cardiopulmonary bypass systems reduce the transfusion rate (odds ratio 0.4, 95% confidence interval 0.26-0.63, P<0.001). This may be because of containment in hemodilution during cardiopulmonary bypass. The better outcome may be related to both this mechanism and the consequent reduction in transfusional needs. Summary Mini-cardiopulmonary bypass systems reduce the need for allogeneic blood transfusions. Other improvements in postoperative outcome are more debated. They require a long learning curve and are more expensive. A cost analysis based on a large randomized controlled trial is still needed to clarify the potential future role of these systems in clinical practice.
KW - Cardiac surgery
KW - Cardiopulmonary bypass
KW - Transfusions
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UR - http://www.scopus.com/inward/citedby.url?scp=62349124110&partnerID=8YFLogxK
U2 - 10.1097/ACO.0b013e32831a408e
DO - 10.1097/ACO.0b013e32831a408e
M3 - Article
C2 - 19237977
AN - SCOPUS:62349124110
VL - 22
SP - 78
EP - 83
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
SN - 0952-7907
IS - 1
ER -