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. 2023 Nov;38(8):1705-1713.
doi: 10.1177/02676591221130173. Epub 2022 Sep 29.

Platelet preservation in cardiac surgery using minimally invasive extracorporeal circulation versus optimized cardiopulmonary bypass

Brian Beairsto  1 , Cyril Serrick  1 , Amanda Fernandez  1 , Myriam Lafreniere-Roula  2 , Mitesh Badiwala  3 , Keyvan Karkouti  4 , Vivek Rao  3
Affiliations

Platelet preservation in cardiac surgery using minimally invasive extracorporeal circulation versus optimized cardiopulmonary bypass

Brian Beairsto et al. Perfusion. 2023 Nov.

Abstract

Background: Minimally invasive extracorporeal circulation (MiECC) is employed as a strategy to attenuate the physiologic disturbance caused by cardiopulmonary bypass. The aim of this study was to compare the coagulation profile of MiECC to an optimized conventional extracorporeal circuit (OpECC) with regards to platelet function, rotational thromboelastometry and blood product usage.

Methods: A retrospective analysis of coronary artery bypass grafting operations using either MiECC or OpECC was performed at a single institution.

Results: A total of 112 patients were included, with 61 receiving MiECC and 51 OpECC patients. OpECC patients had a significantly larger BSA (1.95+/- 0.22m2 vs 1.88 +/- 0.18m2, p = 0.034), than those who received MiECC. No difference between groups was observed regarding red blood cell, plasma, and platelet transfusions. Functional platelet count during the warming phase of cardiopulmonary bypass was found to be higher in the MiECC group ((136 (102-171) x109/L vs 109 (94-136) x109/L), p = 0.027), as were functional platelets as a percent of total platelet count ((86 (77-91)% vs 76 (63-82)%), p = 0.003). There were no significant differences between other outcomes such as operative mortality, incidence of stroke, and intensive care unit length of stay.

Conclusion: While we did not see a difference in blood transfusions, MiECC resulted in a statistically significant advantage over OpECC with regards to preservation of functional platelets.

Keywords: coagulation; extracorporeal circulation; mini-circuit; platelet function.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comparative volume administration. *P<0.001 †P<0.001 ‡P<0.001. CPB = cardiopulmonary bypass. RAP = retrograde autologous prime. CPB = cardiopulmonary bypass.
Figure 2.
Figure 2.
Platelet count and function derived from aggregometry. *P=0.027 †P=0.003. Samples were drawn when 36.0°C was reached during warming phase of cardiopulmonary bypass.
See this image and copyright information in PMC

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