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Umberto Benedetto
Emiliano Angeloni
Simone Refice
Fabio Capuano
Antonino Roscitano
Riccardo Sinatra
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Right arrow Extracorporeal circulation

J Thorac Cardiovasc Surg 2009;138:1450-1453
© 2009 The American Association for Thoracic Surgery

Brief Research Report

Is minimized extracorporeal circulation effective to reduce the need for red blood cell transfusion in coronary artery bypass grafting? Meta-analysis of randomized controlled trials

Umberto Benedetto, MD*, Emiliano Angeloni, MD, Simone Refice, MD, Fabio Capuano, MD, Massimo Goracci, MD, Antonino Roscitano, MD, Riccardo Sinatra, MD

Cardiac Surgery Department, II School of Medicine, University of Rome La Sapienza, Policlinico S. Andrea, Rome, Italy

Received for publication December 2, 2008; accepted for publication March 23, 2009.

* Address for reprints: Umberto Benedetto, MD, Cardiac Surgery Department, II School of Medicine, University of Rome "La Sapienza," Via di Grottarossa 1039. (Email: u2benedetto@libero.it).

The first 20% of the full text of this article appears below.


   Introduction
 
Perioperative red blood cell (RBC) transfusion is the single factor most consistently associated with an increased risk of postoperative morbid events after isolated coronary artery bypass grafting (CABG), and each unit of RBC transfused is associated with incrementally increased risk for adverse outcome.1Go Miniaturized extracorporeal circulation (mini-ECC) has been proposed to limit perioperative blood product use. Mini-ECC consists of a closed ECC system with no cardiotomy suction or venous reservoir. The rationale is to avoid air–blood contact and minimize priming volume, thus reducing hemostasis alteration and intraoperative hemodilution. However, there is still controversy on whether such a strategy effectively reduces postoperative RBC transfusion, with some reports showing no evident benefit.

We conducted a meta-analysis on available randomized controlled trials (RCTs) to evaluate whether mini-ECC decreases the risk of postoperative RBC transfusion compared with conventional ECC in patients undergoing CABG.


   Materials and Methods
 
All RCTs comparing results of isolated CABG on mini-ECC versus conventional ECC were identified using a 2-level search strategy. First, a public domain database (MEDLINE) was searched using a Web-based search . . . [Full Text of this Article]




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