Inflammation is reduced using the Resting Heart Mini-Cardiopulmonary Bypass System in a Prospective Randomized Study
Bob Kiaii, Kelly Summers, Stephanie Fox, Stuart A. Swinamer, Reiza Rayman, Andrew Cleland, Philip Fernandes, James MacDonald, Wojciech Dobkowski, Richard J. Novick; London Health Sciences Centre, London, ON, Canada
Comment on this Abstract
Objective: To compare the systemic inflammatory response of the Resting Heart miniaturized cardiopulmonary bypass (CPB) System (Medtronic, Minneapolis, MN) to two groups utilizing a standard extracorporeal circulation system during on-pump coronary artery bypass grafting (CABG) surgery.
Methods: 60 consecutive patients requiring CABG were prospectively randomized to undergo on-pump CABG using Group A: Conventional CPB without cardiotomy suction; Group B: Conventional CPB Group with cardiotomy suction; or Group C: Resting Heart System. Blood samples were collected at 5 time points: immediately pre-CPB, 30-minutes into CPB, end of CPB, 30-minutes post-CPB, 1-hour post-CPB. Blood was analyzed for changes in plasma levels of (1) the inflammatory cytokines IL-6, IL-8, TNF-alpha, and chemokines MIG and MCP-1 using multiplexed immunoassays, (2) troponin I using ELISA, (3) glucose using a bioanalyzer, plus (4) leukocyte and thrombocyte numbers
Results: MIG secretion was significantly less in Group C than Groups A and B (p = .002). IL-8 (p = .006) and MCP-1 (p = .05) secretion was significantly less in Groups C and A, than Group B. IL-6 (p = .208) and TNF (p = .206) production tended to be lower in Groups C and A, than Group B. Troponin release was significantly less in Groups C and A, compared to Group B (p = .007). Glucose levels were unchanged in all groups. Median leukocyte numbers were similarly increased in all groups. Median thrombocyte numbers increased in Group C, but decreased in Groups A and B (p = .05).
Conclusion: The Medtronic Resting Heart mini-cardiopulmonary bypass System induced less systemic inflammation than Conventional CPB systems, particularly when cardiotomy suction was used.
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