Magnetic levitation pump versus constrained vortex pump: a pilot study on the hemolysis effect during minimal invasive extracorporeal circulation

Abstract

Abstract Background Elevated plasma free hemoglobin is associated with multi-organ injury. In this context, minimally invasive extracorporeal technologies represent a way to reduce this complication following cardiac surgery. Methods We present a pilot study focused on plasma free hemoglobin levels in 40 patients undergoing isolated coronary artery bypass grafting (CABG). The same circuits for minimally invasive extracorporeal circulation (MiECC) were used in all patients. The ECMOLIFE magnetic levitation pump was used in the study group (n = 20), and the AP40 Affinity CP centrifugal blood pump was used in the control group (n = 20). Results In the immediate postoperative period, plasma free hemoglobin (PFH) and lactate dehydrogenase (LDH) were significantly lower in the study group than in the control group (10.6 ± 0.7 vs 19.9 ± 0.3 mg/dL, p = 0.034; and 99.16 ± 1.7 vs 139.17 ± 1.5 IU/L, p = 0.027, respectively). Moreover, patients treated with the magnetic levitation pump showed lower creatinine and indirect bilirubin (0.92 vs 1.29 mg/dL, p = 0.030 and 0.6 ± 0.4 vs 1.5 ± 0.9 mg/dL, p = 0.022, respectively) at 24 h after the procedure, and received fewer transfusions during the whole postoperative period (3 vs 9 red blood cell units (RBC), p = 0.017). Conclusion Our pilot study suggests that the use of magnetically levitated centrifugal pumps for extracorporeal circulation support is associated with a lower risk of hemolysis, though larger studies are warranted to confirm our results.

Keywords

• Cardiopulmonary bypass
• Hemolysis
• Magnetic levitation pump
• Constrained vortex pump
• Minimally invasive extracorporeal circulation
• Coronary artery bypass grafting