Article ; Online: Hemoglobin trends in isolated coronary artery bypass grafting performed off-pump and with standard and mini circuits.
2012 Volume 36, Issue 10, Page(s) 868–874
Abstract: The comparison of hemodilution at the end of surgery is of limited use as it represents only a snapshot of a dynamic phenomenon. This study was undertaken to compare the perioperative hemoglobin curves of isolated coronary artery bypass grafting ... ...
| Abstract | The comparison of hemodilution at the end of surgery is of limited use as it represents only a snapshot of a dynamic phenomenon. This study was undertaken to compare the perioperative hemoglobin curves of isolated coronary artery bypass grafting performed with minimized extracorporeal circulation, traditional cardiopulmonary bypass, and off-pump technique. The propensity score method was used to select three groups of patients, homogenous regarding preoperative and operative data, who underwent isolated coronary artery bypass grafting. A generalized linear mixed model was used for estimating differences in perioperative hemoglobin trends among groups. The three groups were each composed of 50 patients with no differences in demographic data, preoperative risk profile, preoperative hemoglobin, or type of surgery. There was no significant difference in major postoperative complications. The pattern of the hemodilution curves was similar in patients operated with mini-circuit and off-pump technique (P > 005). Mini-circuit led to a 3.1 ± 11.9% hemoglobin reduction, which was similar to the off-pump group (1.6 ± 8.9%, P = 0.99 at ANOVA) and significantly different from the standard extracorporeal circuit group (16.0 ± 10.3%, P < 0.001 at ANOVA). The generalized linear mixed model determined that the standard circuit was the only independent predictor for increased hemodilution. Its effect on hemodilution was time-dependent and the slope of the hemoglobin curve was more pronounced between systemic heparinization and the end of surgery. Perioperative hemoglobin trends of patients who underwent myocardial revascularization with mini-circuit were similar to those of off-pump surgery and significantly less pronounced than those of standard extracorporeal circulation. |
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| MeSH term(s) | Aged ; Cardiopulmonary Bypass/methods ; Coronary Artery Bypass, Off-Pump/methods ; Extracorporeal Circulation/methods ; Female ; Hemodilution ; Hemoglobins/analysis ; Humans ; Male ; Middle Aged ; Prospective Studies | |||||
| Chemical Substances | Hemoglobins | |||||
| Language | English | |||||
| Publishing date | 2012-10 | |||||
| Publishing country | United States | |||||
| Document type | Comparative Study ; Journal Article | |||||
| ZDB-ID | 441812-8 | |||||
| ISSN | 1525-1594 ; 0160-564X | |||||
| ISSN (online) | 1525-1594 | |||||
| ISSN | 0160-564X | |||||
| DOI | 10.1111/j.1525-1594.2012.01481.x | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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