SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery

Background. Platelet count and function are particularly damaged by cardiop ulmonary bypass (CPB). This study evaluated the effects of a novel CPB circ uit in terms of platelet count and activation, and postoperative need for b lood products. Methods. One hundred patients undergoing coronary grafting were randomized in two groups: control group (n = 50) and test group (n = 50, surface modif ying additives circuit, SMA group). Blood samples were taken before, during , and after CPB. Postoperative blood loss, number of transfused blood produ cts, and postoperative variables were recorded. Results. The platelet count decreased less in the SMA group compared to the control group tend of CPB: respectively, 165 +/- 9 x 10(3)/mm(3) vs 137 +/ - 8 x 10(3)/mm(3); p < 0.01). This was paralleled by a reduction in <beta>- thromboglobulin plasma levels in the SMA group. There was a trend to decrea sed blood loss in the SMA group, but the difference was significant only in patients taking aspirin preoperatively (p < 0.05). In the SMA group nearly 50% less fresh frozen plasma and platelet units were administered (p < 0.0 1). No operative deaths were observed. Conclusions. The use of circuits with surface additives is clinically safe, preserves platelet levels, and attenuates platelet activation. This may le ad to a reduced need for blood products. (Ann Thorac Surg 2000;70:2075-81) (C) 2000 by The Society of Thoracic Surgeons.