Key result
The choice of oxygenator (Apex vs Quadrox) did not significantly affect the need for metaraminol due to marked hypotension during cardiopulmonary bypass (80% vs 73%; OR 0.65, 95% CI 0.34-1.22).
Why the study?
Does the choice of Apex oxygenator compared to Quadrox oxygenator reduce marked hypotension requiring metaraminol in patients undergoing non-emergency cardiac surgery with cardiopulmonary bypass?
Cohort (n=218)
Does the choice of Apex oxygenator compared to Quadrox oxygenator reduce marked hypotension requiring metaraminol in patients undergoing non-emergency cardiac surgery with cardiopulmonary bypass?
Odds Ratio: 0.65 (95% CI 0.34–1.22)
Absolute Event Rate: 80% vs 73%
p-value: p=0.18
The choice between Apex and Quadrox oxygenators during cardiopulmonary bypass does not significantly affect the incidence of marked hypotension requiring metaraminol.
No difference in metaraminol use between oxygenators; observational data leave open any causal impact on hypotension during bypass.
Cardiopulmonary bypass (CPB) exposes blood to artificial surfaces, which induces a systemic inflammatory activation.This may contribute to hypotension during CPB. A perceived difference between two membrane oxygenators was noted. Data were collected on 222 consecutive patients; four were excluded from the analysis due to having emergency operations. One hundred and twelve (51%) patients received the Apex oxygenator whilst 106 (49%) received the Quadrox. There was no difference between the two groups in the primary outcome; 90/112 patients (80%) in the Apex group and 77/106 (73%) in the Quadrox group (p=0.18, OR: 0.65; 95% CI: 0.34, 1.22) received meteraminol due to marked hypotension during CPB. There was also no difference in the secondary outcomes, length of stay in ICU (22.8 versus 22.7 hours, (OR 0.79, 95% CI: 0.42, 1.48, p=0.16) and length of stay in hospital (8.5 days versus 8.0 days (OR: 0.83, 95% CI: 0.48, 1.45; p=0.52). The choice of oxygenator between the Apex and Quadrox does not have an effect on hypotension in cardiac surgery.
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Mijovski et al. (2011) conducted a cohort in Cardiopulmonary bypass (n=218). Apex oxygenator vs. Quadrox oxygenator was evaluated on Received meteraminol due to marked hypotension during CPB (OR 0.65, 95% CI 0.34-1.22, p=0.18). The choice of oxygenator (Apex vs Quadrox) did not significantly affect the need for metaraminol due to marked hypotension during cardiopulmonary bypass (80% vs 73%; OR 0.65, 95% CI 0.34-1.22).
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