PMID- 15939621
OWN - NLM
STAT- MEDLINE
DCOM- 20051017
LR  - 20061115
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 28
IP  - 1
DP  - 2005 Jul
TI  - Comparison of minimally invasive closed circuit extracorporeal circulation with 
      conventional cardiopulmonary bypass and with off-pump technique in CABG patients: 
      selected parameters of coagulation and inflammatory system.
PG  - 127-32
AB  - OBJECTIVE: Closed circuit extracorporeal circulation (CCECC) has been developed 
      to reduce deleterious effects of standard cardiopulmonary bypass (CPB). This 
      study compares the effects of CCECC (CORx system), CPB, and off-pump coronary 
      artery bypass grafting (OPCAB) on red blood cell damage, coagulation activation, 
      fibrinolysis and cytokine expression. METHODS: Thirty patients underwent coronary 
      artery bypass grafting (CABG). Twenty of them were randomized into two groups: 
      CCECC (n = 10), CPB (n = 10). While not randomized, OPCAB (n = 10) served as a 
      separate reference group. CCECC and CPB patients received cardioplegic arrest. 
      Interleukin 6 (IL-6), free hemoglobin (fHb), von Willebrand factor activity 
      (vWf), thrombin-antithrombin-III-complex (TATc), prothrombin fragment 1.2 (F 1+2) 
      and plasmin-antiplasmin complex (PAPc) were assessed preoperatively, 
      perioperatively and 24 h postoperatively. RESULTS: CCECC showed significantly 
      lower red blood cell damage than CPB (fHb: CCECC, 7.1+/- 5.7 micromol/l; CPB, 
      16.8+/-11.4 micromol/l; P = 0.025; OPCAB, 3.4+/-1.1 micromol/l). Perioperatively, 
      CCECC exhibited significantly lower activation of coagulation and fibrinolysis 
      than CPB, but did not differ from OPCAB (vWf: CCECC, 133+/-52%; CPB, 241+/-128%; 
      P = 0.052; OPCAB, 153+/-58%; TATc: CCECC, 4.7+/-0.9 ng/ml; CPB, 31.1+/-15.8 
      ng/ml; P < 0.001; OPCAB, 2.4+/-0.6 ng/ml; PAPc: CCECC, 214+/-30 ng/ml; CPB, 
      897+/-367 ng/ml; P < 0.001; OPCAB, 253+/-98 ng/ml). In contrast, fibrinolysis 
      markers and IL-6 were markedly increased in CCECC postoperatively (PAPc: CCECC, 
      458+/-98 ng/ml; CPB, 159+/-128 ng/ml; P < 0.001; OPCAB, 262+/-174 ng/ml; IL-6: 
      CCECC, 123.4+/-49.8 pg/dl; CPB, 18.8+/-13.1 pg/dl; P < 0.001; OPCAB, 31.6+/-26.2 
      pg/dl). CONCLUSIONS: CCECC for CABG is associated with a significant reduction of 
      red blood cell damage and activation of coagulation cascades similar to OPCAB 
      when compared with conventional CPB while a delayed fibrinolytic and inflammatory 
      activity was observed. These findings require further investigation to verify the 
      promising concept of CCECC.
FAU - Wippermann, Jens
AU  - Wippermann J
AD  - Department of Cardiothoracic and Vascular Surgery, University Hospital Jena, 
      Erlanger Allee 101, 07747 Jena-Lobeda, Germany. jens.wippermann@med.uni-jena.de
FAU - Albes, Johannes M
AU  - Albes JM
FAU - Hartrumpf, Martin
AU  - Hartrumpf M
FAU - Kaluza, Mirko
AU  - Kaluza M
FAU - Vollandt, Rudiger
AU  - Vollandt R
FAU - Bruhin, Raimund
AU  - Bruhin R
FAU - Wahlers, Thorsten
AU  - Wahlers T
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 0 (Inflammation Mediators)
RN  - 0 (Interleukin-6)
SB  - IM
MH  - Acute-Phase Reaction
MH  - Adult
MH  - Aged
MH  - Blood Coagulation
MH  - Cardiopulmonary Bypass
MH  - Coronary Artery Bypass/*methods
MH  - Coronary Artery Bypass, Off-Pump
MH  - Extracorporeal Circulation/*methods
MH  - Female
MH  - Fibrinolysis
MH  - Hemolysis
MH  - Humans
MH  - Inflammation Mediators/blood
MH  - Interleukin-6/blood
MH  - Male
MH  - Middle Aged
MH  - Platelet Activation
MH  - Platelet Count
MH  - Postoperative Period
EDAT- 2005/06/09 09:00
MHDA- 2005/10/18 09:00
CRDT- 2005/06/09 09:00
PHST- 2004/09/15 00:00 [received]
PHST- 2005/03/04 00:00 [revised]
PHST- 2005/03/31 00:00 [accepted]
PHST- 2005/06/09 09:00 [pubmed]
PHST- 2005/10/18 09:00 [medline]
PHST- 2005/06/09 09:00 [entrez]
AID - S1010-7940(05)00275-7 [pii]
AID - 10.1016/j.ejcts.2005.03.032 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2005 Jul;28(1):127-32. doi: 10.1016/j.ejcts.2005.03.032.