Minimally invasive cardiopulmonary bypass: Does it really change the outcome?

Marco Ranucci, Giuseppe Isgrò

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Introduction: Many innovative cardiopulmonary bypass (CPB) systems have recently been proposed by the industry. With few differences, they all share a philosophy based on priming volume reduction, closed circuit with separation of the surgical field suction, centrifugal pump, and biocompatible circuit and oxygenator. These minimally invasive CPB (MICPB) systems are intended to limit the deleterious effects of a conventional CPB. However, no evidence exists with respect to their effectiveness in improving the postoperative outcome in a large population of patients. This study aimed to verify the clinical impact of an MICPB in a large population of patients undergoing coronary artery revascularization. Methods: We conducted a retrospective analysis of 1,663 patients treated with an MICPB. The control group (conventional CPB) was extracted from a series of 2,877 patients according to a propensity score analysis. Results: Patients receiving an MICPB had a shorter intensive care unit (ICU) stay, had lower peak postoperative serum creatinine and bilirubin levels, and suffered less postoperative blood loss. Within a multivariable model, MICPB is independently associated with lower rates of atrial fibrillation (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.69 to 0.99) and ventricular arrhythmias (OR 0.45, 95% CI 0.28 to 0.73) and with higher rates of early discharge from the ICU (OR 1.31, 95% CI 1.06 to 1.6) and from the hospital (OR 1.46, 95% CI 1.18 to 1.8). Hospital mortality did not differ between groups. Conclusion: MICPBs are associated with reduced morbidity. However, these results will need to be confirmed in a large, prospective, randomized, controlled trial.

Original languageEnglish
Article numberR45
JournalCritical Care
Volume11
DOIs
Publication statusPublished - Apr 15 2007

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Cardiopulmonary Bypass
Odds Ratio
Confidence Intervals
Intensive Care Units
Oxygenators
Postoperative Hemorrhage
Propensity Score
Suction
Hospital Mortality
Bilirubin
Atrial Fibrillation
Population
Cardiac Arrhythmias
Creatinine
Coronary Vessels
Industry
Randomized Controlled Trials
Morbidity
Control Groups
Serum

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Minimally invasive cardiopulmonary bypass : Does it really change the outcome? / Ranucci, Marco; Isgrò, Giuseppe.

In: Critical Care, Vol. 11, R45, 15.04.2007.

Research output: Contribution to journalArticle

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