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Ann Thorac Surg 2000;70:2075-2081
© 2000 The Society of Thoracic Surgeons
a Department of Cardiovascular Surgery, Center for Experimental Surgery (CREDEC), and Department of Anesthesiology, Laboratory of Thrombosis Hemostasis, University Hospital of Liège, Liège, Belgium
Accepted for publication April 27, 2000.
Address reprint requests to Dr Defraigne, CHU Liège, Domaine Universitaire du Sart-Tilman, 4000 Liège, Belgium
e-mail: jo.defraigne{at}chu.ulg.ac.be
Background. Platelet count and function are particularly damaged by cardiopulmonary bypass (CPB). This study evaluated the effects of a novel CPB circuit in terms of platelet count and activation, and postoperative need for blood products.
Methods. One hundred patients undergoing coronary grafting were randomized in two groups: control group (n = 50) and test group (n = 50, surface modifying additives circuit, SMA group). Blood samples were taken before, during, and after CPB. Postoperative blood loss, number of transfused blood products, and postoperative variables were recorded.
Results. The platelet count decreased less in the SMA group compared to the control group (end of CPB: respectively, 165 ± 9 x 103/mm3 vs 137 ± 8 x 103/mm3; p < 0.01). This was paralleled by a reduction in ß-thromboglobulin plasma levels in the SMA group. There was a trend to decreased blood loss in the SMA group, but the difference was significant only in patients taking aspirin preoperatively (p < 0.05). In the SMA group nearly 50% less fresh frozen plasma and platelet units were administered (p < 0.01). No operative deaths were observed.
Conclusions. The use of circuits with surface additives is clinically safe, preserves platelet levels, and attenuates platelet activation. This may lead to a reduced need for blood products.
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