• Chiara Giorni, Chiara Pezzella, Mirela Bojan, Zaccaria Ricci, Philippe Pouard, Olivier Raisky, Laurent Tourneur, Ondina La Salvia, Isabella Favia, Delphine Borgel, Paola Cogo, Adriano Carotti, and Dominique Lasne.
• Pediatric Intensive Care, Cardiac Surgery and Perfusion Unit, Bambino Gesù Children's Hospital, Rome, Italy. Electronic address: c_giorni@yahoo.it.
• Ann. Thorac. Surg. 2019 Apr 1; 107 (4): 1241-1247.

BackgroundExtracorporeal circuit coating has been shown to improve coagulation derangements during pediatric cardiopulmonary bypass (CPB). This study compared platelet function and hemostasis activation in pediatric cardiac surgery conducted with nonheparin coating (Balance; Medtronic, Minneapolis, MN) versus heparin-based coating (Carmeda; Medtronic) circuits.MethodsA prospective, randomized, double-center trial was conducted in children older than 1 month undergoing congenital heart disease treatment. Blood samples were collected at baseline (T0), 15 minutes after the start of CPB (T1), and 15 minutes (T2) and 1 hour after the conclusion of CPB (T3). The primary end point of the study was to detect potential differences in β-thromboglobulin levels between the two groups at T2. Other coagulation and platelet function indicators were analyzed as secondary end points.ResultsThe concentration of β-thromboglobulin increased significantly at T2 in both groups. However, there was no significant difference between the groups across all time points. There was no difference in the secondary end points between the groups.ConclusionsThe two circuits showed similar biological effects on platelet function and coagulation. This observation may be useful in optimizing the conduct of CPB and in rationalizing its cost for the treatment of congenital heart disease.Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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