Does a centrifugal pump improve platelet retention during cardiopulmonary bypass compared to a conventional roller pump in adult patients undergoing cardiac surgery?
The use of a centrifugal pump during cardiopulmonary bypass significantly improves intraoperative platelet retention compared to a conventional roller pump, particularly in prolonged cases, older patients, and high-risk surgical scenarios.
Preservation of platelet count during cardiopulmonary bypass (CPB) was retrospectively studied in 784 consecutive adult patients undergoing cardiac surgery, including high-risk “special case” patients. The extracorporeal circuit included a closed membrane oxygenator system for all patients. A roller pump (Co be Laboratories or Stockert-Shiley) was used for bypass in one group of 564 patients, while a centrifugal pump (BioPump, BioMedicus) was used in a second group of 220 patients. There was no difference between the roller and centrifugal pump groups with respect to age, sex, total bypass time, and pre-bypass platelet count. For purposes of this study, retention refers to the patient's last platelet count on CPB expressed as a fraction of the pre-CPB platelet count. The centrifugal pump group had a higher platelet retention than the roller pump group (.619 vs .595, p 120 min) had a lower platelet retention in the roller pump group (.568 vs .610, p.05). Patients OVer the age of 70 had a lower retention than those under 70 in the roller pump group (.576 VS .604, p.05). The special case patients had a lower retention when the roller pump was used (.563 vs .607, p.05), however bypass time was also prolonged in the special case group. The centrifugal pump results in improved platelet retention on cardiopulmonary bypass. This improvement is most notable in prolonged cases(> 120 min), in older patients(> 70 yrs), and in special cases.
Parault et al. (Sat,) studied this question.