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J. Cardiothorac. Vasc. Anesth. · Oct 2005
Randomized Controlled Trial Comparative StudyHeparin-bonded cardiopulmonary bypass circuits reduce the rate of red blood cell transfusion during elective coronary artery bypass surgery.
- Kenneth R Kreisler, Robert A Vance, Jose Cruzzavala, and Jonathan D Mahnken.
- Department of Anesthesiology, University of Kansas, Kansas City, KS 66160, USA. kkreisler@kumc.edu
- J. Cardiothorac. Vasc. Anesth. 2005 Oct 1;19(5):608-11.
ObjectiveThis study compared the transfusion rates of patients treated with heparin-bonded circuits with the transfusion rates of patients treated with standard bypass circuits with and without -aminocaproic acid (EACA).DesignProspective double-blind (drugs), open trial (cardiopulmonary bypass circuits).SettingUniversity medical center.ParticipantsSeventy-one patients undergoing elective am admission coronary artery bypass graft surgery.Measurements And Main ResultsPatients were randomized to receive either heparin-coated cardiopulmonary bypass circuits (HBCPB), nonheparin-coated cardiopulmonary bypass circuits and EACA (EACPB), or nonheparin-coated bypass circuits and placebo (control). Patients were transfused if their hematocrit was <18% while on cardiopulmonary bypass or <25% at any time after the cardiopulmonary bypass period. The rate and number of transfused packed red blood cells (pRBCs), platelets, fresh frozen plasma, and cryoprecipitate were measured. A Fisher exact test showed that the transfusion rate was as follows: the HBCPB group (5.0%), the EACPB group (18.2%), and the control group (36%), (p = 0.034).ConclusionsThe heparin-bonded cardiopulmonary bypass-treated patients in this study received fewer pRBCs than did the control group. A nonsignificant reduction in the pRBC transfusion rate was found between those with heparin-bonded bypass circuits and those with standard circuits who received epsilon-aminocaproic acid.
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