RESUMO
OBJECTIVE: To evaluate the safety and effects on blood transfusion of modified minimally cardiopulmonary bypass (CPB). METHODS: From April 2013 to February 2016, 1 103 elective cardiac surgery cases in National Center for Cardiovascular Diseases China, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were prospectively enrolled in the study. Patients undergoing modified minimally CPB were assigned to mini-CPB group (n=553), the others undergoing conventional CPB were assigned to conventional group (n=550). In mini-CPB group, oxygenator with integrated arterial filter, modified minimized circuit, mini-cardioplegia and vacuum assisted venous drainage(VAVD) were used. In conventional group, conventional CPB was composed with conventional oxygenator from the same manufactory, conventional circuit and 1â¶4 blood cardioplegia. Analysis was performed with t test, t' test, Wilcoxon rank-sum test, χ(2) test, and Fisher exact test. RESULTS: No CPB accidents and peri-operative stroke were observed. There was no statistical difference in postoperative mechanical ventilation time, length of ICU stay, postoperative complications and mortality between the two groups. The incidence of erythrocyte transfusion (13.7% vs. 27.6%, χ(2)=32.458, P=0.000) and the incidence of ultrafilter (11.0% vs. 33.7%, χ(2)=76.019, P=0.000) were lower in the mini-CPB group. Postoperative hematocrit (M(QR): 32.9 (5.7) vs. 32.2 (5.7), Z=3.403, P=0.001) and 12-hour chest drainage ((228±154) ml vs.(260±197) ml, t'=3.004, P=0.003) of mini-CPB were imporved compared with conventional group. CONCLUSIONS: Modified minimally CPB is safe. It might reduce erythrocyte transfusion for adult cardiac surgery, warranting widely adoption.