INFLUENCE OF 2 BLOOD CONSERVATION TECHNIQUES (CARDIOTOMY RESERVOIR VERSUS CELL-SAVER) ON BIOCOMPATIBILITY OF THE HEPARIN-COATED CARDIOPULMONARY BYPASS CIRCUIT DURING CORONARY REVASCULARIZATION SURGERY

Blood conservation during cardiac surgery is critically important beca use of the inherent risks in homologous blood transfusions. Two techni ques for the intraoperative conservation of blood-retransfusion of the red cells using a cell-saver (CS), or retransfusion of the blood usin g a cardiotomy suction (CTR) system-were compared using biocompatibili ty markers, granulocyte activation, and production of oxygen-free radi cals (OFR). In the CTR group, heparin coated circuits with an uncoated cardiotomy reservoir were used. For the CS group, identical heparin c oated cardiopulmonary bypass (CPB) sets, without a cardiotomy reservoi r but with a CS, were used. In each group, eight patients had coronary artery bypass grafting performed. The capacity of the whole blood and the granulocytes to produce OFR was estimated by a chemiluminescence, and granulocyte activation was measured as release of the granulocyte granule proteins myeloperoxidase (MPO) and lactoferrin. A significant ly reduced capacity to produce OFR by the whole blood was noted at 45 minutes of CPB in the CTR group (68% +/- 17% vs 94% +/- 16% in the CS group). MPO release was higher after 3 hours (p = 0.05) and 20 hours ( p < 0.05), postoperatively, in the CTR group (417 +/- 77 mu g/L and 25 7 +/- 31 mu g/L vs 246 +/- 25 mu g/L and 164 +/- 12 mu g/L, respective ly, in the CS group). We conclude that the heparin coated CPB circuit with the uncoated cardiotomy reservoir may be less biocompatible than the identical CPB set used together with the CS.