La réduction de surface de la circulation extracorporelle améliore les résultats

Introduction: Since 1999, we have tried to lessen the effects of cardiopulmonary bypass (CPB) by reducing the surface of the extracorporeal circulation (ECC). Encouraged by the results of our fi rst compact ECC, we have decided to improve it by implementing other techniques such as controlled hemodilution of the patient without variation of arterial pressure, vacuum assisted venous drainage (VAVD) and the sequestration of autologous blood within the fi rst minute of CPB. The purpose of this study is to evaluate the effects of compact ECC on the postoperative period. Methods: Three groups of patients undergoing CABG are compared. Groups 1 and 2 are historical groups. Group 1 covers 50 patients operated from 1999-2001. Group 2 covers 25 patients operated from May 01 to August 2001. Group 3 new compact ECC covers 25 patients enrolled from 2003-2004. Results: Our new compact ECC (Group 3) shows improved outcomes through reduced postoperative ventilation time, blood loss, intensive care stay, need for blood transfusion and levels of lactate dehydrogenase. Conclusions : Optimization of CPB and its use have a direct impact on the postoperative outcome of the patient. This strategy of ameliorating CPB allows to operate on more fragile and more complicated patients. Larger prospective randomized study is necessary to confi rm these fi ndings.